Fact Sheets & Frequently Asked Questions (FAQs)

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menu-item--collapsed"> <a href="/medicare/medicaid-coordination/center-program-integrity/resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/674936">Resources</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/medicaid-coordination/about/qualified-medicare-beneficiary-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/184631">Qualified Medicare beneficiary program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/medicaid-coordination/center-program-integrity/spotlight" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/674941">Spotlight</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/medicaid-coordination/center-program-integrity/events" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/674946">Events</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/financial-alignment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/178246">Financial alignment initiative</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/avoidable-hospitalizations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/181236">Initiative to reduce avoidable hospitalizations </a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/medicaid-coordination/center-program-integrity/reports-guidance" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/674951">Reports & Guidance</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/medicaid-coordination/pace" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175651">Program of All-Inclusive Care for the Elderly (PACE)</a> </li> <li class="menu-item 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<a href="/medicare/appeals-grievances/managed-care" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169961">Managed Care appeals & grievances</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/appeals-grievances/prescription-drug" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171101">Medicare Prescription drug appeals & grievances</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/appeals-grievances/ombudsman-center" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193386">Ombudsman Center</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/appeals-grievances/appeals-decision-search-part-c-d" class="menu-item-element" aria-current="false" data-drupal-link-system-path="qic-decision-search">Appeals Decision Search (Part C & Part D)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Quality</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/value-based-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/188566">Value-based programs</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/quality/initiatives/hospital-quality-initiative/person-family-engagement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/182996">Person & Family Engagement</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/quality-improvement-organizations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169871">Quality improvement organizations</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/nursing-home-improvement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171236">Nursing home quality improvement</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/inpatient-rehabilitation-facility" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175616">Inpatient Rehabilitation Facility (IRF) Quality Reporting Program (QRP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/home-health" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170541">Home Health Quality Reporting Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/end-stage-renal-disease-esrd-quality-incentive-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176126">ESRD Quality Incentive Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/meaningful-measures-initiative/cms-quality-strategy" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/178276">CMS National Quality Strategy</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/hospice" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175556">Hospice Quality Reporting Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/long-term-care-hospital" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175511">Long-Term Care Hospital (LTCH) Quality Reporting Program (QRP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/appropriate-use-criteria-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/180421">Appropriate Use Criteria Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/measures" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172001">Quality measures</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/clinical-laboratory-improvement-amendments" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172651">Clinical Laboratory Improvement Amendments (CLIA)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/advantage-quality-improvement-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177561">Medicare Advantage quality improvement program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/physician-compare-initiative" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175221">Physician compare initiative</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/initiatives" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169636">Quality initiatives</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/part-c-d-performance-data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171491">Part C and D Performance Data</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/quality/snf-quality-reporting-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/180061"> Skilled Nursing Facility (SNF) Quality Reporting Program (QRP)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health & safety standards</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/quality-safety-oversight-general-information" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169631">Quality, safety & oversight - General information</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/accreditation-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171481">Accreditation programs</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/civil-monetary-penalties" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/182431">Civil monetary penalties</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/quality-safety-oversight-emergency-preparedness" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172346">Quality, safety & oversight - Emergency preparedness</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/state-survey-agencies" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171271">State survey agencies</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/certification-compliance" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171241">Certification & compliance</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/enforcement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/169811">Enforcement</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/guidance-for-laws-regulations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170071">Quality, safety & oversight - Guidance for laws & regulations</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/promising-practices-project" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172211">Promising practices project</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-safety-standards/education-division" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/173371">Quality, safety & oversight - Education division (QSED)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-safety-standards/conditions-coverage-participation" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172616">Conditions for coverage & participation</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Employers & plan sponsors</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/employers-plan-sponsors/creditable-coverage" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171701">Creditable coverage</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">IC-Placeholder-1</span> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Audits & Compliance</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/audits-compliance/part-a-cost-report" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/185256">Part A cost report audit</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/audits-compliance/part-c-d" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175921">Part C/Part D compliance & audits</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Forms & notices</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/medicare/forms-notices/cms-forms" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170166">CMS forms</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/forms-notices/cms-forms-list" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/174306">CMS forms list</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/forms-notices/beneficiary-notices-initiative" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170686">Beneficiary Notices Initiative (BNI)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health & drug plans</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/plan-payment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171981">Plan payment</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/plan-payment-data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175081">Plan payment data</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/medical-loss-ratio" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/180161">Medical loss ratio</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/coverage-gap-discount-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/175906">Coverage Gap Discount Program</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/managed-care-marketing" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170611">Managed care marketing</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/medicare-advantage-application" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170651">Medicare Advantage application</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/medigap" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170466">Medigap (Medicare supplement health insurance)</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/medical-savings-account" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/172066">Medical Savings Account (MSA)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/health-drug-plans/private-fee-for-service-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170301">Private Fee-for-Service Plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/enrollment-renewal/health-plans/prepayment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170521">Health Care Prepayment Plans (HCPPs)</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/enrollment-renewal/health-plans/cost" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170656">Cost plans</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/enrollment-renewal/special-needs-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171676">Special needs plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/health-drug-plans/network-adequacy" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/171301">Network adequacy</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Coordination of benefits & recovery</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/overview" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177001">Overview</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/mandatory-insurer-reporting-group-health-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176856">Mandatory Insurer Reporting for Group Health Plans (GHP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/mandatory-insurer-reporting" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176951">Mandatory insurer reporting (NGHP)</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/workers-comp-set-aside-arrangements" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176641">Workers' comp Medicare set aside arrangements</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/attorney-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177026">Attorney services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/beneficiary-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/177036">Beneficiary services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/coba-trading-partners" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176761">COBA Trading Partners</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/employer-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170361">Employer services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/insurer-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170846">Insurer services</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/prescription-drug-assistance-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/176791">Prescription drug assistance programs</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicare/coordination-benefits-recovery/provider-services" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/170406">Provider services</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Settlements</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/medicare/settlements/jimmo" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193381">Jimmo Settlement</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicare/settlements/ryan" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193486">Ryan Settlement</a> </li> </ul> </div> </div> </li> </ul> </div> </li> <li class="menu-item menu-item--l1 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Medicaid/CHIP</span> <div class="subnav-wrapper--1 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-main ds-u-lg-display--none">Back to main menu</span> <h2 class="subnav-title-h2" style="position:relative;text-align:left;width:auto;height:auto;">section title h2</h2> </div> <ul class="menu"> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">What is Medicaid?</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="https://www.medicaid.gov" class="menu-item-element" aria-current="false">Visit Medicaid.gov</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.medicaid.gov/about-us/beneficiary-resources/index.html#statemenu" class="menu-item-element" aria-current="false">View Medicaid maps</a> </li> <li class="menu-item menu-item--l3"> <a href="http://www.medicaid.gov/chip/index.html" class="menu-item-element" aria-current="false">Visit CHIP.gov</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Medicare-Medicaid Coordination</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/medicaid-chip/medicare-coordination/integrated-care-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/174926">Integrated care resources</a> </li> <li class="menu-item menu-item--l3"> <a href="/medicaid-chip/medicare-coordination/avoidable-hospitalizations" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/181236">Initiative to reduce avoidable hospitalizations</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/financial-alignment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/178246">Financial alignment initiative</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/medicaid-chip/medicare-coordination/integrity-institute" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1315141">Medicaid Integrity Institute</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">RG-Placeholder-1</span> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">IC-Placeholder-2</span> </li> </ul> </div> </li> <li class="menu-item menu-item--l1 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Marketplace & Private Insurance</span> <div class="subnav-wrapper--1 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-main ds-u-lg-display--none">Back to main menu</span> <h2 class="subnav-title-h2" style="position:relative;text-align:left;width:auto;height:auto;">section title h2</h2> </div> <ul class="menu"> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">About the Marketplace</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/about/oversight" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191061">Marketplace oversight</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/about/affordable-care-act" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191416">Affordable Care Act</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/about/overview-exchanges" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190921">Overview of the exchanges</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/about/exchange-coverage-maps" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193086">Exchange coverage maps</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/about/medicare" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/179351">Medicare and the Marketplace</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Private Health Insurance</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/patient-bill-of-rights" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192591">Patient’s Bill of Rights</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/medical-loss-ratio" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190956">Medical loss ratio</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/annual-limits" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191976">Annual limits</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/review-insurance-rates" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192716">Review of insurance rates</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/market-rating-reforms" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191816">Market rating</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/self-funded-non-federal-governmental-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191111">Self-funded, non-federal governmental plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/grandfathered-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191456">Grandfathered plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/health-reimbursement-arrangements" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193216">Health Reimbursement Arrangements</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/coverage-young-adults" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190931">Coverage for young adults</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/student-health-plans" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190946">Student health plans</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/mental-health-parity-addiction-equity" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192601">Mental health parity and addiction equity</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/prevention" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191071">Prevention</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/consumer-protections-enforcement" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192701">Consumer protections & enforcement</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/private-health-insurance/pre-existing-condition-plan" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191056">Pre-existing condition insurance plan</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/glossary/qualifying-health-coverage" class="menu-item-element" aria-current="false">Qualifying Health Coverage (QHC)</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2"> <span class="menu-item-element" aria-current="false">RG-Placeholder-2</span> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">In-person assisters</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/in-person-assisters/information-partners" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2078851">Information for Partners</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/outreach-education" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073436">Assister outreach & education</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/applications-forms-notices" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073441">Applications, forms, & notices</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/programs-procedures" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073446">Assister programs & procedures</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/technical-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073231">Assister technical resources</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/in-person-assisters/training-webinars" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2073451">Assister training & webinars</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Agents & Brokers</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192876">Resources for Agent & Brokers</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/registration-training" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1290426">Registration & training</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/open-enrollment" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193226">Open enrollment</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/direct-enrollment-partners" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1550226">Direct enrollment partners</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/general-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/185021">General resources</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.youtube.com/playlist?list=PLaV7m2-zFKpgUK9AqdbnOdW69-WwodvRj" class="menu-item-element" aria-current="false">Video Learning Center</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.agentbrokerfaq.cms.gov/s/" class="menu-item-element" aria-current="false">Agent & Broker FAQ</a> </li> <li class="menu-item menu-item--l3"> <a href="/files/document/agent/broker-help-desks.pdf" class="menu-item-element" aria-current="false" data-drupal-link-system-path="media/112386">Marketplace help desk & call centers</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/ffm_ab_registration_lists" class="menu-item-element" aria-current="false">Registration Completion List</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/ab-registration-tracker/" class="menu-item-element" aria-current="false">Marketplace Registration Tracker</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/ab-suspension-and-termination-list" class="menu-item-element" aria-current="false">AB Suspension & Termination List</a> </li> <li class="menu-item menu-item--l3"> <a href="https://localhelp.healthcare.gov/" class="menu-item-element" aria-current="false">Find local help</a> </li> <li class="menu-item menu-item--l3"> <a href="https://data.healthcare.gov/issuer-partner-lookup" class="menu-item-element" aria-current="false">Issuer and direct enrollment partner directory</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/help-on-demand" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193196">Help on demand</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/agents-brokers/shop-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193096">SHOP Resources</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health Plans & Issuers</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/qualified-health-plan-certification" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191371">Qualified health plan certification </a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/summary-benefits-coverage" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191461">Summary of benefits & coverage</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/health-plans-issuers/insurance-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192101">Insurance programs</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/health-plans-issuers/premium-stabilization-programs" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191326">Premium stabilization programs</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/insurance-market-reforms" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191421">Health insurance market reforms</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/health-plans-issuers/minimum-essential-coverage" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192891">Minimum essential coverage</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace-private-insurance/health-plans-issuers/pbm-drug-pricing-review" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2088761">Drug pricing & rebate review</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Employers & sponsors</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/other-coverage" class="menu-item-element" aria-current="false">Coverage</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/choose-and-enroll/shop-marketplace-overview" class="menu-item-element" aria-current="false">Regulation & guidance</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/choose-and-enroll/qualify-for-shop-marketplace" class="menu-item-element" aria-current="false">Small business tax credit & premium assistance</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/small-businesses/choose-and-enroll/appeal-a-shop-decision" class="menu-item-element" aria-current="false">Appeals</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/employers-sponsors/small-business-health-options-program-shop" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192901">Small Business Health Options Program (SHOP)</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/employers-sponsors/early-retiree-reinsurance-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191651">Early retiree reinsurance program</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/employer-initiatives" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192916">Employer initiatives</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">States</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/state-marketplace-resources" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190916">Planning & establishing a Marketplace</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/territory-cooperative-agreements" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190926">Territory cooperative agreements</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/early-innovator-program" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191691">Early innovator program</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/state-flexibility-stabilize-market" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/193246">State flexibility to stabilize the Market </a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/states/creating-competitive-marketplace" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192231">Exchange establishment grants</a> </li> <li class="menu-item menu-item--l3"> <a href="https://www.healthcare.gov/coverage/pre-existing-conditions" class="menu-item-element" aria-current="false">Pre-existing condition insurance plan</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Resources</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/about-us" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/192721">About Us</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/marketplace/resources/data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191741">Data resources</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/forms-reports-other" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/190966">Forms, reports, & other resources</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/letters" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191646">Letters</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/regulations-guidance" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191366">Regulations & Guidance</a> </li> <li class="menu-item menu-item--l3"> <a href="/marketplace/resources/training" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/191466">Training resources</a> </li> </ul> </div> </div> </li> </ul> </div> </li> <li class="menu-item menu-item--l1 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Priorities</span> <div class="subnav-wrapper--1 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-main ds-u-lg-display--none">Back to main menu</span> <h2 class="subnav-title-h2" style="position:relative;text-align:left;width:auto;height:auto;">section title h2</h2> </div> <ul class="menu"> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Innovation Center</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/priorities/innovation/overview" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2090631">Overview</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/about" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2074091">About</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/key-concepts" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072461">Key Concepts</a> </li> <li class="menu-item menu-item--l3"> <a href="/priorities/innovation-center/model-data" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2087691">Model Data</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation-center/value-based-care-spotlight" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2082926">Value-Based Care Spotlight</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/models" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072436">Innovation Models</a> </li> <li class="menu-item menu-item--l3"> <a href="/priorities/innovation/where-innovation-happening" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072451">Where Innovation is Happening</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/innovation/evaluation-research-reports" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072446">Evaluations & Research Reports</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Health Equity</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/c2c" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1974361">Coverage to Care</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/minority-health" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1620916">Minority health</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/c2c/es" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/2072591">Cobertura de atención</a> </li> <li class="menu-item menu-item--l3 menu-item--collapsed"> <a href="/priorities/health-equity/grants-awards" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1612961">Grants & awards</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Recent Legislation</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/inflation-reduction-act-and-medicare" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1621896">Inflation Reduction Act and Medicare</a> </li> <li class="menu-item menu-item--l3"> <a href="/nosurprises" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1573261">No Surprises Act</a> </li> </ul> </div> </div> </li> <li class="menu-item menu-item--l2 menu-item--expanded"> <span class="menu-item-element" aria-current="false">Key Initiatives</span> <div class="subnav-wrapper--2 ds-u-display--none"> <div class="subnav-header"> <span class="back-to-l2 ds-u-lg-display--none">Back to <span class="l2-placeholder"></span> menu</span> <h3 class="subnav-title-h3" style="position:relative;text-align:left;">section title h3</h3> </div> <div class="menu-wrapper"> <ul class="menu"> <li class="menu-item menu-item--l3"> <a href="/priorities/key-initiatives/opioids" class="menu-item-element" aria-current="false" data-drupal-link-system-path="node/1620416">Opioids</a> </li> <li 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data-drupal-link-system-path="node/178211">Employers & unions</a> </li> </ul> </div> </div> </li> </ul> </div> </li> </ul> </nav> </div> </div> </div> </div> </div> <div class="header-breadcrumb-wrapper ds-u-display--none ds-u-md-display--block cms-tracker--breadcrumbs"> <div class="ds-l-container"> <div class="ds-l-row"> <div class="ds-l-col--12 ds-u-display--flex ds-u-justify-content--between ds-u-align-items--center"> <div id="block-cms-evo-breadcrumbs" class="block block-system block-system-breadcrumb-block"> <div class="content"> <span class="create-date"> </span> <nav class="breadcrumb" aria-label="Breadcrumb"> <ul class="menu cms-evo-unstyled-list"> <li> <a href="/" title="CMS Home" class="linked-breadcrumb"><i class="fas fa-home"></i></a> <i class="fas fa-angle-right"></i> </li> <li> <a href="/marketplace/in-person-assisters/information-partners" class="linked-breadcrumb">Health Insurance Marketplace</a> <i class="fas fa-angle-right"></i> </li> <li> Resources <i class="fas fa-angle-right"></i> </li> <li> Fact Sheets & Frequently Asked Questions (FAQs) </li> </ul> </nav> </div> </div> </div> </div> </div> </div> </header> <div id="page-wrapper" class="ds-l-container"> <div id="page"> <main id="skipNavTarget" role="main"> <div id="main-wrapper" class="clearfix"> <div class="region region-cms-page-menu-block-header"> </div> <div id="main" class="clearfix"> <div class="ds-l-row">   <div class="ds-l-col--12 cms-global-center"> <inner> <div class="region region-content"> <div data-drupal-messages-fallback class="hidden"></div> <div id="block-cms-evo-pagetitle" class="block block-core block-page-title-block"> <div class="content"> <span class="create-date"> </span> <h1 class="page-title"><span class="field field--name-title field--type-string field--label-visually_hidden">Fact Sheets & Frequently Asked Questions (FAQs) <div class="title-border"></div></span> </h1> <div class="title-border"></div> </div> </div> <div id="block-cms-evo-content" class="block block-system block-system-main-block"> <div class="content"> <span class="create-date"> </span> <article class="node node--type-section-page node--view-mode-full clearfix"> <div class="node__content clearfix"> <div class="field field--name-body field--type-text-with-summary field--label-hidden field__item"><div class="rxbodyfield"><ul><li><a href="#COVID-19">Coronavirus Disease 2019 (COVID-19)</a></li><li><a href="#Affordable_Care_Act">Affordable Care Act</a></li><li><a href="#Consumer_Support_and_Information">Consumer Support and Information</a><ul><li><a href="#Consumer_Assistance_Program_Grants">Consumer Assistance Program Grants</a></li><li><a href="#External_Appeals">External Appeals</a></li><li><a href="#Summary_of_Benefits_and_Coverage_and_Uniform_Glossary">Summary of Benefits and Coverage and Uniform Glossary</a></li><li><a href="#Outreach_and_Education_Resources">Outreach and Education Resources</a></li><li><a href="#Taglines">Language Access Taglines for Exchanges, Qualified Health Plan (QHP) Issuers, and Web-Brokers</a></li></ul></li><li><a href="#Content_Requirements_for_Plan_Finder">Content Requirements for Plan Finder</a></li><li><a href="#Pre-Existing Condition Insurance Plan (PCIP)">Pre-Existing Condition Insurance Plan (PCIP)</a></li><li><a href="#Health_Insurance_Marketplaces">Health Insurance Marketplaces</a><ul><li><a href="#In-Person Assistance">In-Person Assistance</a></li><li><a href="#Plan_Management">Plan Management</a></li><li><a href="#Exchange_Planning_and_Establishment_Grants">Planning and Establishment Grants</a></li><li><a href="#Early_Innovator_Grants">Early Innovator Grants</a></li><li><a href="#Territory_Cooperative_Agreements">Territory Cooperative Agreements</a></li></ul></li><li><a href="#Premium_Stabilization_Programs">Premium Stabilization Programs</a></li><li><a href="#Consumer Operated and Oriented Plan (CO-OP) Program">Consumer Operated and Oriented Plan (CO-OP) Program</a></li><li><a href="#Other_Insurance_Protections">Other Insurance Protections</a><ul><li><a href="#COBRA">COBRA</a></li><li><a href="#Mental_Health_Parity">Mental Health Parity</a></li><li><a href="#Newborns_and_Mothers_Health_Protection">Newborns' and Mothers' Health Protection</a></li><li><a href="#Womens_Health_and_Cancer_Rights">Women's Health and Cancer Rights</a></li></ul></li><li><a href="#Health_Market_Reforms">Health Insurance Market Reforms</a><ul><li><a href="#Annual_Limits">Annual Limits</a></li><li><a href="#Coverage_for_Young_Adults">Coverage for Young Adults</a></li><li><a href="#Grandfathered_Plans">Grandfathered Plans</a></li><li><a href="#Medical_Loss_Ratio">Medical Loss Ratio</a></li><li><a href="#Prevention">Prevention</a></li><li><a href="#Review_of_Insurance_Rates">Review of Insurance Rates</a></li><li><a href="#Student_Health_Plans">Student Health Plans</a></li><li><a href="#Self-Funded Non-Federal Governmental Plans">Self-Funded Non-Federal Governmental Plans</a></li></ul></li></ul><p>Additional FAQs and resources related to the Affordable Care Act may be available on other agencies’ websites, including:</p><ul><li> <span class="mceNonEditable rx_inlinevariant"> </span><a href="http://business.usa.gov/healthcare" title="BusinessUSA.gov - Opens in a new window" target="T169549"><span class="mceNonEditable rx_inlinevariant">BusinessUSA.gov </span><span class="mceNonEditable rx_inlinevariant LinkDisclaimer">- Opens in a new window</span></a><span class="mceNonEditable rx_inlinevariant"> </span> </li><li> <span class="mceNonEditable rx_inlinevariant"> </span><a href="http://www.dol.gov/ebsa/healthreform/" title="Department of Labor - Opens in a new window" target="T169550"><span class="mceNonEditable rx_inlinevariant">Department of Labor</span><span class="mceNonEditable rx_inlinevariant LinkDisclaimer"> - Opens in a new window</span></a><span class="mceNonEditable rx_inlinevariant"> </span> </li><li> <span class="mceNonEditable rx_inlinevariant"> </span><a href="http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions-Home" title="Department of Treasury - Opens in a new window" target="T169551"><span class="mceNonEditable rx_inlinevariant">Department of Treasury</span><span class="mceNonEditable rx_inlinevariant LinkDisclaimer"> - Opens in a new window</span></a><span class="mceNonEditable rx_inlinevariant"> </span> </li><li> <span class="mceNonEditable rx_inlinevariant"> </span><a href="http://www.opm.gov/healthcare-insurance/multi-state-plan-program/" title="Office of Personnel Management - Opens in a new window" target="T169552"><span class="mceNonEditable rx_inlinevariant">Office of Personnel Management</span><span class="mceNonEditable rx_inlinevariant LinkDisclaimer"> - Opens in a new window</span></a><span class="mceNonEditable rx_inlinevariant"> </span> </li></ul><h2><a class="ck-anchor" id="COVID-19"></a>Coronavirus Disease 2019 (COVID-19) Guidance </h2><p><strong>FAQs</strong></p><ul><li>March 5, 2020<br><a href="/files/document/03052020-individual-small-market-covid-19-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="f418d79a-d7b8-4cb9-bafd-313493b39a51" data-entity-substitution="canonical" title="03.05.2020 Individual Small Market COVID 19 Fact Sheet">Information Related to COVID–19 Individual and Small Group Market Insurance Coverage (PDF)</a></li><li>March 12, 2020<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/ehb-benchmark-coverage-of-covid-19.pdf" data-entity-type="media" data-entity-uuid="e57c2c05-5c10-44f7-a8e1-78e236ac5803" data-entity-substitution="canonical" title="EHB-Benchmark-Coverage-of-COVID-19">FAQs on Essential Health Benefits Coverage and the Coronavirus (COVID-19) (PDF)</a></li><li>March 18, 2020<br><a href="/cciio/resources/files/catastrophic-coverage-of-covid-19.pdf" data-entity-type="media" data-entity-uuid="1e6427b0-fd2c-48e0-9a99-e580eece94e2" data-entity-substitution="canonical" title="Catastrophic-Coverage-of-COVID-19">FAQs on Catastrophic Plan Coverage and the Coronavirus Disease 2019 (COVID-19) (PDF)</a></li><li>March 24, 2020<br><a href="/files/document/faqs-telehealth-covid-19.pdf" data-entity-type="media" data-entity-uuid="a3dc9b0d-deec-4bbb-a51c-895917b17b26" data-entity-substitution="canonical" title="FAQs-on-Telehealth-COVID-19">FAQs on Availability and Usage of Telehealth Services through Private Health Insurance Coverage in Response to Coronavirus Disease 2019 (COVID-19) (PDF)</a></li><li>March 24, 2020<br><a href="/files/document/faqs-payment-and-grace-period-covid-19.pdf" data-entity-type="media" data-entity-uuid="f963e528-c646-42e8-b10d-98a588ac17c1" data-entity-substitution="canonical" title="FAQs-on-Payment-and-Grace-Period-COVID-19">Payment and Grace Period Flexibilities Associated with the COVID-19 National Emergency (PDF)</a></li><li>March 24, 2020<br><a href="/files/document/faqs-rx-covid-19.pdf" data-entity-type="media" data-entity-uuid="c785e875-0ab5-4a8f-9c17-16aac50372ea" data-entity-substitution="canonical" title="FAQs-on-Rx-COVID-19">FAQs on Prescription Drugs and the Coronavirus Disease 2019 (COVID-19) for Issuers Offering Health Insurance Coverage in the Individual and Small Group Markets (PDF)</a></li><li><span>April 11, 2020 </span><br><a href="/files/document/ffcra-part-42-faqs.pdf" data-entity-type="media" data-entity-uuid="58f18615-661d-45da-b4f9-734df4819003" data-entity-substitution="canonical" title="FFCRA-Part-42-FAQs">FAQs <span class="msoIns">about Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act Implementation</span> (Set 42) (PDF)</a><br>*<span class="msoIns">This document was updated on April 15, 2020, to correct an error in footnote 10 regarding the current end date of the public health emergency related to COVID-19.</span></li><li><span>April 13, 2020</span><br><a href="/files/document/2019-hhs-radv-postponement-memo.pdf" data-entity-type="media" data-entity-uuid="6f29f509-b9b0-453b-9487-fbcc2822a52f" data-entity-substitution="canonical" title="2019-HHS-RADV-Postponement-Memo"><span>Postponement of 2019 Benefit Year HHS-operated Risk Adjustment Data Validation (HHS-RADV)</span> (PDF)</a></li><li><span>April 18, 2020</span><br><a href="/files/document/covid-qrs-and-marketplace-quality-initiatives-memo-final.pdf" data-entity-type="media" data-entity-uuid="565eddaa-2859-4223-a7b3-667d24e3fe33" data-entity-substitution="canonical" title="COVID QRS and Marketplace Quality Initiatives Memo Final"><span>COVID-19 and Suspension of Certain Activities Related to the Health Insurance Exchange Quality Rating System, QHP Enrollee Experience Survey (QHP Enrollee Survey) and Quality Improvement Strategy Program (PDF)</span></a><span> </span></li><li>April 21, 2020<br><a href="/cciio/programs-and-initiatives/health-insurance-marketplaces/downloads/faqs-issuer-flex-um-pa.pdf" data-entity-type="media" data-entity-uuid="3dffaf64-b2cd-4995-8d2e-4df168882caf" data-entity-substitution="canonical" title="FAQs-Issuer-Flex-UM-PA ">FAQs on Issuer Flexibilities for Utilization Management and Prior Authorization (PDF)</a></li><li>April 27, 2020</li><li><a href="/files/document/cciioratelehealthfaq042720.pdf" data-entity-type="media" data-entity-uuid="f5983a91-ecae-4155-b78e-b58a1744378a" data-entity-substitution="canonical" title="CCIIO_RA_Telehealth_FAQ042720">Risk Adjustment <span>Telehealth and Telephone Services During</span> COVID-19 (PDF)</a><br>This guidance document was updated by the below April 11, 2023, Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs.</li><li>May 12, 2020<br><a href="/files/document/qrs-qis-and-qhp-survey-covid-19-draft-faq-issuers.pdf" data-entity-type="media" data-entity-uuid="79c494ef-2f16-4173-ad94-225c9d473587" data-entity-substitution="canonical" title="QRS QIS and QHP Survey-COVID-19 Draft FAQ Issuers"><span class="MsoHyperlink">Quality Rating System (QRS), Qualified Health Plan (QHP) Enrollee Experience Survey, and Quality Improvement Strategy (QIS) FAQs in Response to the Coronavirus (COVID-19) Pandemic </span> (PDF)</a></li><li>May 14, 2020<br><a href="/files/document/temporary-relaxed-enforcement-of-group-market-timeframes.pdf" data-entity-type="media" data-entity-uuid="65adba48-b041-4411-94aa-95633384c844" data-entity-substitution="canonical" title="Temporary Relaxed Enforcement Of Group Market Timeframes">Temporary Period of Relaxed Enforcement of Certain Timeframes Related to Group Market Requirements under the Public Health Service Act in Response to the COVID-19 Outbreak (PDF)</a> </li><li>June 5, 2020<br><a href="/files/document/covid-19-letter-to-non-federal-governmental-plans.pdf" data-entity-type="media" data-entity-uuid="884e5c54-c0e6-4f0c-ba61-52829e44aa70" data-entity-substitution="canonical" title="COVID-19-Letter-to-Non-Federal-Governmental-Plans">Letter to Sponsors of non-Federal Governmental Plans Regarding COVID-19 Guidance (PDF)</a></li><li>June 12, 2020<br><a href="/files/document/issuing-2019-mlr-rebates-in-response-to-covid-19.pdf" data-entity-type="media" data-entity-uuid="eefbbf68-9c81-4487-9897-13dbd4d866a3" data-entity-substitution="canonical" title="Issuing-2019-MLR-Rebates-in-Response-to-COVID-19">Temporary Period of Relaxed Enforcement for Submitting the 2019 MLR Annual Reporting Form and Issuing MLR Rebates in Response to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PDF)</a></li><li>June 23, 2020<br><a href="/files/document/ffcra-part-43-faqs.pdf" data-entity-type="media" data-entity-uuid="bdc25041-03dc-4f6a-ba76-35bfd5669bbe" data-entity-substitution="canonical" title="FFCRA-Part-43-FAQs">FAQs <span>about Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act Implementation (set 43)</span> (PDF)</a></li><li>June 29, 2020<br><a href="/cciio/programs-and-initiatives/health-insurance-marketplaces/downloads/mental-health-substance-use-disorder-resources-covid-19.pdf" data-entity-type="media" data-entity-uuid="c97dbcdf-242c-44d8-bc4a-f3b3b1b569ea" data-entity-substitution="canonical" title="Mental-Health-Substance-Use-Disorder-Resources-COVID-19">Leveraging Existing Health and Disease Management Programs to Provide Mental Health and Substance Use Disorder Resources During the COVID-19 Public Health Emergency (PHE) (PDF)</a></li><li>August 3, 2020</li><li><a href="/files/document/cciioratelehealthfaq080320.pdf" data-entity-type="media" data-entity-uuid="84fe6eb7-53ca-48c6-9b5c-a97d359470ae" data-entity-substitution="canonical" title="CCIIO_RA_Telehealth_FAQ080320">Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs  (PDF)</a><br>This guidance document was updated by the below April 11, 2023, Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs.</li><li>August 4, 2020<br><a href="/cciio/programs-and-initiatives/health-insurance-marketplaces/downloads/premium-credit-guidance.pdf" data-entity-type="media" data-entity-uuid="5bd8fdc2-6c2a-4c91-993c-93ea464780bd" data-entity-substitution="canonical" title="Premium Credit Guidance">Temporary Policy on 2020 Premium Credits Associated with the COVID-19 Public Health Emergency (PDF)</a></li><li>August 25, 2020<br><a href="/files/document/cciio-premium-reductions-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="bef3d9ca-25d2-4803-a2a7-2b47655dce5a" data-entity-substitution="canonical" title="CCIIO-Premium-Reductions-Fact-Sheet">Technical Fact Sheet: CCIIO Premium Reductions:  Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (PDF)</a></li><li>August 25, 2020<br><a href="/files/document/covid-ifc-3-8-25-20.pdf" data-entity-type="media" data-entity-uuid="5d147c4f-7e08-4d3b-aa10-d7b69cb37061" data-entity-substitution="canonical" title="COVID IFC 3 8 25 20">Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (PDF)</a></li><li>October 28, 2020<br><a href="/files/document/covid-vax-ifc-4.pdf" data-entity-type="media" data-entity-uuid="375f448c-493f-41ea-80e0-a4795974c9f5" data-entity-substitution="canonical" title="COVID & VAX IFC 4 ">Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency Interim Final Rule (CMS-9912-IFC) (PDF)</a></li><li>October 28, 2020<br><a href="/covidvax">COVID-19 Vaccines:  Information for Providers, Health Insurance Issuers, State Medicaid Programs, and Children’s Health Insurance Programs (CHIP) and Basic Health Programs (BHP)</a></li><li>January 7. 2021 (Updated)<br><a href="/files/document/covid-19-toolkit-issuers-ma-plans.pdf-1" data-entity-type="media" data-entity-uuid="5249fc70-df99-4c38-879a-054169f00b96" data-entity-substitution="canonical" title="COVID-19-toolkit-issuers-MA-plans">Toolkit on COVID-19 Vaccine:  Health Insurance Issuers and Medicare Advantage Plans (PDF)</a></li><li>February 26, 2021<br><a href="/files/document/faqs-part-44.pdf" data-entity-type="media" data-entity-uuid="ab582e2e-3eba-43a6-998a-7eb49795fbb8" data-entity-substitution="canonical" title="FAQs-Part-44">FAQs about Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 44) (PDF)</a><br>* Some of the guidance in FAQs Set 44 has been superseded by guidance contained in FAQs Set 50. <br>** The Provider Relief Fund, described in Q14 in FAQs set 44, no longer accepts claims for testing, treatment, or COVID-19 vaccination.</li><li><a>May 6, 2021</a></li><li><a href="/files/document/cciioratelehealthfaq05062021508.pdf" data-entity-type="media" data-entity-uuid="d4a04277-9b16-4e9f-914a-e3f5abab9ccb" data-entity-substitution="canonical" title="CCIIO_RA_Telehealth_FAQ_05062021_508">Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs (PDF)</a><br>This guidance document was updated by the below April 11, 2023, Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs.</li><li>August 16,  2021 (Updated—replaces the July 23. 2021 version)<br><a href="/files/document/covid-19-toolkit-issuers-ma-plans.pdf-1" data-entity-type="media" data-entity-uuid="5249fc70-df99-4c38-879a-054169f00b96" data-entity-substitution="canonical" title="COVID-19-toolkit-issuers-MA-plans">Toolkit on COVID-19 Vaccine:  Health Insurance Issuers and Medicare Advantage Plans (PDF)</a></li><li>November 1, 2021<br><a href="/files/document/2021-sgm-premium-credit-guidance.pdf" data-entity-type="media" data-entity-uuid="8e5e3c79-0618-4395-b223-dd2af3920494" data-entity-substitution="canonical" title="2021-SGM-Premium-Credit-Guidance">Temporary Policy on 2021 Premium Credits in the Small Group Market Only Associated with the COVID-19 Public Health Emergency (PDF)</a></li><li>December 17,  2021 (Updated—replaces the August 16. 2021 version)<br><a href="/files/document/covid-19-toolkit-issuers-ma-plans.pdf-1" data-entity-type="media" data-entity-uuid="5249fc70-df99-4c38-879a-054169f00b96" data-entity-substitution="canonical" title="COVID-19-toolkit-issuers-MA-plans">Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans (PDF)</a></li><li>December 29,  2021 (Updated—replaces the December 17, 2021 version)<br><a href="/files/document/covid-19-toolkit-issuers-ma-plans.pdf-1" data-entity-type="media" data-entity-uuid="5249fc70-df99-4c38-879a-054169f00b96" data-entity-substitution="canonical" title="COVID-19-toolkit-issuers-MA-plans">Toolkit on COVID-19 Vaccine:  Health Insurance Issuers and Medicare Advantage Plans (PDF)</a></li><li>January 10,  2022<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-51.pdf" data-entity-type="media" data-entity-uuid="3b4f761a-4279-4b2f-8feb-568421e45eb0" data-entity-substitution="canonical" title="FAQs-Part-51">FAQs about Affordable Care Act Implementation, Families First Coronavirus Response Act, and Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 51) (PDF)</a><br>This set of FAQs addresses rapid coverage of COVID-19 diagnostic testing and coverage of preventive services, including contraceptive services.</li><li>January 10,  2022<br><a href="/how-to-get-your-at-home-otc-covid-19-test-for-free" data-entity-type="node" data-entity-uuid="a65539af-5cb8-417b-9b0a-1423ec7e0600" data-entity-substitution="canonical" title="How to get your At-Home Over-The-Counter COVID-19 Test for Free">How to get your At-Home Over-The-Counter COVID-19 Test for Free</a></li><li>February 4, 2022<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-52.pdf" data-entity-type="media" data-entity-uuid="465ffe0a-35a4-456d-ac69-780b1a383dd5" data-entity-substitution="canonical" title="aca-part-52">Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 52) (PDF)</a></li><li>April 6, 2022<br><a href="/files/document/covid-19-toolkit-issuers-ma-plans.pdf-1" data-entity-type="media" data-entity-uuid="5249fc70-df99-4c38-879a-054169f00b96" data-entity-substitution="canonical" title="COVID-19-toolkit-issuers-MA-plans">Toolkit on COVID-19 Vaccine: Health Insurance Issuers and Medicare Advantage Plans (PDF)</a></li><li>April 29, 2022<br><a href="/files/document/ra-telehealth-faq.pdf" data-entity-type="media" data-entity-uuid="eac3add5-c531-492d-acd4-9d33dbc25994" data-entity-substitution="canonical" title="RA-Telehealth-FAQ">Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs (PDF) (PDF)</a><br>This guidance document was updated by the below April 11, 2023, Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs.</li><li>March 29, 2023<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-58.pdf" data-entity-type="media" data-entity-uuid="9d1acb04-2569-4443-8a24-1cfd240b97f4" data-entity-substitution="canonical" title="FAQs-Part-58">FAQs about Families First Coronavirus Response Act, Coronavirus Aid, Relief, and Economic Security Act and Health Insurance Portability and Accountability Act Implementation (Set 58) (PDF)</a></li><li>April 11, 2023<br><a href="/files/document/cciio-ra-telehealth-faq04112023.pdf" data-entity-type="media" data-entity-uuid="df150a63-e822-4aa4-891a-d4dfb9481a5c" data-entity-substitution="canonical" title="CCIIO RA Telehealth FAQ04112023">Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs (PDF)</a><br>This guidance document replaces previous Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs listed above.</li><li>April 13, 2023<br><a href="/files/document/faqs-part-59.pdf" data-entity-type="media" data-entity-uuid="93938ee2-adb6-4d3d-ae4a-7cc6288fe059" data-entity-substitution="canonical" title="FAQs-Part-59">FAQs about Affordable Care Act and Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 59) (PDF)</a></li><li>May 13, 2024<br><a href="/files/document/telehealth-faq-2024-update-51324-clean.pdf" data-entity-type="media" data-entity-uuid="758bbc70-ca12-42e9-94b9-83a630608b76" data-entity-substitution="canonical" title="Telehealth FAQ 2024 update 5.13.24 clean">Risk Adjustment Telehealth and Audio-only Services FAQ (PDF)</a><br>This guidance document replaces previous Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs listed above.</li></ul><h2><a class="ck-anchor" id="Affordable_Care_Act"></a>Affordable Care Act</h2><p><strong>FAQs</strong></p><ul><li>September 20, 2010<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs" data-entity-type="node" data-entity-uuid="e68e2a3e-7319-4e67-a145-862692db701c" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 1">Affordable Care Act Implementation FAQs (Set 1)</a><br>This set of FAQs addresses implementation topics including compliance, grandfathered health plans, claims, internal appeals and external review, dependent coverage of children, out-of-network emergency services, and highly compensated employees.</li><li>October 8, 2010<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs2" data-entity-type="node" data-entity-uuid="93ddcd20-aa6d-42d2-98b3-b3d48acd9291" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 2">Affordable Care Act Implementation FAQs (Set 2)</a><br>This set of FAQs addresses grandfathered health plans, dental and vision benefits, rescissions, preventive health services, and ACA effective date for individual health insurance policies.</li><li>October 12, 2010<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs3" data-entity-type="node" data-entity-uuid="8b801b16-c5ef-4393-b3fd-088c3fe6bdbc" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 3">Affordable Care Act Implementation FAQs (Set 3)</a><br>This set of FAQs addresses the exemption for group health plans with less than two current employees.</li><li>October 29, 2010<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs4" data-entity-type="node" data-entity-uuid="2787e226-ab6b-41fa-b599-96b36a43438e" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 4">Affordable Care Act Implementation FAQs (Set 4)</a><br>This set of FAQs addresses grandfathered health plans.</li><li>December 22, 2010<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs5" data-entity-type="node" data-entity-uuid="a42ee5a3-c242-48cf-98b1-75e0af39ec9b" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 5">Affordable Care Act Implementation FAQs (Set 5)</a><br>This set of FAQs addresses a variety of ACA implementation topics, the HIPAA nondiscrimination and wellness program rules, and the Mental Health Parity and Addiction Equity Act of 2008.</li><li>April 1, 2011<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs6" data-entity-type="node" data-entity-uuid="1bcf1e56-345c-4280-9d9e-7afb4f55499c" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 6">Affordable Care Act Implementation FAQs (Set 6)</a><br>This set of FAQs addresses grandfathered health plans.</li><li>November 17, 2011<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs7" data-entity-type="node" data-entity-uuid="be7c97bd-8637-42fc-982d-3560081fd657" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 7">Affordable Care Act Implementation FAQs (Set 7)</a><br>This set of FAQs addresses the Summary of Benefits and Coverage and Uniform Glossary requirements of PHS Act §2715 and the Mental Health Parity and Addiction Equity Act of 2008.</li><li>February 9, 2012<br><a href="/cciio/resources/files/downloads/employer_faq_bulletin_2_9_12_final.pdf" data-entity-type="media" data-entity-uuid="5aadde2c-83c8-4b0c-a039-737d586078e5" data-entity-substitution="canonical" title="employer_faq_bulletin_2_9_12_final">Frequently Asked Questions from Employers Regarding Automatic Enrollment, Employer Shared Responsibility, and Waiting Periods (PDF - 93 KB) (PDF)</a><br>This Bulletin provides information on questions from employers and other stakeholders regarding the provisions of the Affordable Care Act governing automatic enrollment, employer shared responsibility, and the 90-day limitation on waiting periods.</li><li>March 19, 2012<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs8" data-entity-type="node" data-entity-uuid="743c78a0-0327-4525-8b3f-ca9193c0ecf9" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 8">Affordable Care Act Implementation FAQs (Set 8)</a><br>This set of FAQs addresses the Summary of Benefits and Coverage requirements of PHS Act §2715.<br>*Updated February 15, 2022</li><li>May 11, 2012<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs9" data-entity-type="node" data-entity-uuid="45248893-54e3-46c4-be20-9ccaa01ab1d0" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 9">Affordable Care Act Implementation FAQs (Set 9)</a><br>This set of FAQs addresses the Summary of Benefits and Coverage requirements of PHS Act §2715.</li><li>August 7, 2012<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs10" data-entity-type="node" data-entity-uuid="c843a5c8-a23c-4402-8b1c-93ba99dd0bf7" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 10">Affordable Care Act Implementation FAQs (Set 10)</a><br>This FAQ addresses the Summary of Benefits and Coverage requirements of PHS Act §2715.</li><li>January 24, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs11" data-entity-type="node" data-entity-uuid="9c69cbdb-6bc1-46f6-8a7f-34e0211bd3c3" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 11">Affordable Care Act Implementation FAQs (Set 11)</a><br> This set of FAQs addresses the employer's notice of coverage options, health reimbursement arrangements, disclosure of information related to firearms, employer group waiver plans supplementing Medicare Part D, fixed indemnity insurance and payment of PCORI fees. Related information: <a href="/cciio/resources/files/downloads/part-d-bulletin-1-25-2013.pdf" data-entity-type="media" data-entity-uuid="ac2e81a8-37da-42a4-aef0-09ca6ae2f454" data-entity-substitution="canonical" title="part-d-bulletin-1-25-2013">CMS Bulletin (PDF)</a> on Non-Medicare Supplemental Drug Benefits.<br>(**Note: See <a href="https://www.dol.gov/agencies/ebsa/employers-and-advisers/guidance/technical-releases/13-03">Technical Release 2013-03</a> for comprehensive guidance addressing health reimbursement arrangements that were issued after the date of these FAQs.).</li><li>February 20, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs12" data-entity-type="node" data-entity-uuid="059b5cc9-2db5-41b7-8b69-890ae369a76d" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 12">Affordable Care Act Implementation FAQs (Set 12)</a><br>This set of FAQs addresses limitations on cost-sharing under the ACA and coverage of preventive services under the ACA.</li><li>March 8, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs13" data-entity-type="node" data-entity-uuid="5812ceec-1fa4-4bbd-89d8-baac9a1bfc3c" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 13">Affordable Care Act Implementation FAQs  (Set 13)</a><br>This set of FAQs addresses expatriate health plans.</li><li>April 23, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs14" data-entity-type="node" data-entity-uuid="f5038145-8961-4272-a59b-cd326a8632cf" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 14">Affordable Care Act Implementation FAQs (Set 14)</a><br>This set of FAQs addresses the Summary of Benefits and Coverage requirements of PHS Act §2715.</li><li>April 29, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs15" data-entity-type="node" data-entity-uuid="3a42e267-f4c2-41c5-ad50-8162bc56508b" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 15">Affordable Care Act Implementation FAQs (Set 15)</a><br>This set of FAQs addresses annual limit waiver expiration date based on a change to a plan or policy year, provider non-discrimination, coverage for individuals participating in approved clinical trials and transparency reporting.</li><li>September 4, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs16" data-entity-type="node" data-entity-uuid="3df8920c-8b04-4133-ac7c-4a4057a85194" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 16">Affordable Care Act Implementation FAQs (Set 16)</a><br>This set of FAQs addresses the employer notice of coverage options and the 90-day waiting period limitation.</li><li>November 8, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs17" data-entity-type="node" data-entity-uuid="2514eeb2-482f-412a-8c39-108ca874246f" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 17">Affordable Care Act Implementation FAQs (Set 17)</a><br>This set of FAQs addresses the implementation of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Affordable Care Act.</li><li>January 9, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs18" data-entity-type="node" data-entity-uuid="7bceba8c-3c23-4e3b-be8b-62a9836c79cf" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 18">Affordable Care Act Implementation FAQs (Set 18)</a><br>This set of FAQs addresses coverage of preventive services, limitations on cost-sharing, expatriate health plans, wellness programs, fixed indemnity insurance, and the Mental Health Parity and Addiction Equity Act of 2008.</li><li>May 2, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs19" data-entity-type="node" data-entity-uuid="b4e9d811-24f6-44fd-a0dd-07fe8ab0ebce" data-entity-substitution="canonical" title="FAQs About Affordable Care Act Implementation (Part XIX)">Affordable Care Act Implementation FAQs (Set 19)</a><br>This set of FAQs addresses updated DOL model notices, limitations on cost-sharing, coverage of preventive services, health FSA carryover and excepted benefits, and the Summary of Benefits and Coverage requirements of PHS Act §2715.</li><li>July 17, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-aca20.pdf" data-entity-type="media" data-entity-uuid="2ee4f542-cfe4-4bd2-8ce6-155f9edc2914" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs (Set 20)">Affordable Care Act Implementation FAQs (Set 20) (PDF)</a><br>This set of FAQs addresses coverage of preventive services.</li><li>October 10, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/reference_pricing_faq_101014.pdf" data-entity-type="media" data-entity-uuid="025c903e-6d39-4e50-96d8-abb0551c8f80" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs (Set 21)">Affordable Care Act Implementation FAQs (Set 21) (PDF)</a><br>This set of FAQs addresses limitations on cost sharing under the ACA.</li><li>November 6, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-xxii-final.pdf" data-entity-type="media" data-entity-uuid="8890f376-e983-46a0-9975-e2ac2f24f7c6" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs (Set 22)">Affordable Care Act Implementation FAQs (Set 22) (PDF)</a><br>This set of FAQs addresses compliance of premium reimbursement arrangements.</li><li>February 13, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/supplmental-faq_2-13-15-final.pdf" data-entity-type="media" data-entity-uuid="7e4e0ae9-101c-40a5-bdf4-ca333e2f4ccc" data-entity-substitution="canonical" title="Supplmental FAQ_2-13-15 final">Affordable Care Act Implementation FAQs (Set 23) (PDF)</a><br>This set of FAQs addresses excepted benefits.</li><li>March 30, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs24" data-entity-type="node" data-entity-uuid="f586bf53-59b9-48fc-8064-fb437821e1b8" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 24">Affordable Care Act Implementation FAQs (Set 24)</a><br>This set of FAQs addresses proposed changes to the SBC regulations, as well as a new SBC template and associated documents.</li><li> April 16, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/tri-agency-wellness-faqs-4-16-15pdf-adobeacrobat-pro.pdf" data-entity-type="media" data-entity-uuid="6a48267e-9d11-4816-a53e-2fb5a175592f" data-entity-substitution="canonical" title="Affordable Care Act Implementation (Set 25)">Affordable Care Act Implementation FAQs (Set 25) (PDF)</a><br>This set of FAQs addresses the wellness program requirements.</li><li>May 11, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/aca_implementation_faqs26.pdf" data-entity-type="media" data-entity-uuid="5ad2aab7-46b8-4557-9291-5abf1621fb19" data-entity-substitution="canonical" title="aca_implementation_faqs26">Affordable Care Act Implementation FAQs (Set 26) (PDF)</a><br>This set of FAQs addresses coverage of preventive services.</li><li>May 26, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/aca-faqs-part-xxvii-moop-2706-final.pdf" data-entity-type="media" data-entity-uuid="7e082a9a-2b9b-44bc-a658-db464098e8b9" data-entity-substitution="canonical" title="ACA FAQs Part XXVII (MOOP 2706) FINAL">Affordable Care Act Implementation FAQs (Set 27) (PDF)</a><br>This set of FAQs addresses limitations on cost sharing and provider non-discrimination.</li><li>August 11, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/aca-faq-part-xxviii-transparency-reporting-final-8-11-15.pdf" data-entity-type="media" data-entity-uuid="38e2de70-f012-4451-a2f0-0a04104db75b" data-entity-substitution="canonical" title="Affordable Care Act Implementation (Set 28)">Affordable Care Act Implementation FAQs (Set 28) (PDF)</a><br>This set of FAQs addresses transparency reporting for non-QHP issuers and non-grandfathered group health plans.</li><li>October 23, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-xxix.pdf" data-entity-type="media" data-entity-uuid="d3960539-56b6-4f53-876f-37fc6c9f88c8" data-entity-substitution="canonical" title="Affordable Care Act Implementation (Set 29)">Affordable Care Act Implementation FAQs (Set 29) (PDF)</a><br>This set of FAQs addresses coverage of preventive services, wellness programs, and the Mental Health Parity and Addiction Equity Act of 2008.</li><li>March 11, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-30_final-3-11-16.pdf" data-entity-type="media" data-entity-uuid="b57b665b-c938-4de2-bd86-979f467b971b" data-entity-substitution="canonical" title="FAQS 30_final 3 11 16">Affordable Care Act Implementation FAQs (Set 30) (PDF)</a><br>This set of FAQs addresses the summary of benefits and coverage (SBC)</li><li>April 20, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-31_final-4-20-16.pdf" data-entity-type="media" data-entity-uuid="72a6268b-7c05-4ba9-b1f2-7201f758502b" data-entity-substitution="canonical" title="FAQs 31_Final 4-20-16">Affordable Care Act Implementation FAQs (Set 31) (PDF)</a><br>This set of FAQs addresses coverage of preventive services, rescissions, out-of-network emergency services, coverage for individuals participating in approved clinical trials, limitations on cost-sharing under the Affordable Care Act, the Mental Health Parity and Addiction Equity Act and the Women's Health and Cancer Rights Act.</li><li>June 21, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-32_final-6-21-16.pdf" data-entity-type="media" data-entity-uuid="dacbed6a-c5e1-4a49-9ddd-f4414cfa7c06" data-entity-substitution="canonical" title="FAQS-32_Final-6-21-16">Affordable Care Act Implementation FAQs (Set 32) (PDF)</a><br>This set of FAQs addresses notice of coverage options – COBRA and the Health Insurance Marketplace.</li><li>October 21, 2016<br><a href="/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/ACA-FAQ-Set-33-Final.pdf">Affordable Care Act Implementation FAQs (Set 33) (PDF)</a><br><a href="/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/ACA-FAQ-Set-33-Final.pdf">(PDF) (PDF)</a>This set of FAQs addresses premium reduction arrangements for student health plan coverage</li><li>October 27, 2016<br><a href="/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/FAQ-part-34_10-26-16_FINAL.PDF">Affordable Care Act Implementation FAQs (Set 34) (PDF)</a><br><a href="/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/FAQ-part-34_10-26-16_FINAL.PDF">(PDF) (PDF)</a>This set of FAQs addresses coverage of preventive services under the Affordable Care Act and the Mental Health Parity and Addiction Equity Act</li><li>December 20, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-part-35_12-20-16.pdf" data-entity-type="media" data-entity-uuid="a20688f5-e07b-400c-bf27-90c19d8c1cc8" data-entity-substitution="canonical" title="FAQ-Part-35_12-20-16">Affordable Care Act Implementation FAQs (Set 35) (PDF)</a><br>This set of FAQs addresses special enrollment for group health plans, coverage of preventive services under the Affordable Care Act and qualified small employer health reimbursement arrangements.</li><li>January 9, 2017<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/aca-faqs-part36_1-9-17-final.pdf" data-entity-type="media" data-entity-uuid="7de73d76-3159-4e76-bbe7-76d7e0ec4f69" data-entity-substitution="canonical" title="ACA FAQs Part 36 1 9 17 Final">Affordable Care Act Implementation FAQs (Set 36) (PDF)</a><br>This set of FAQs addresses coverage of preventive services</li><li>January 12, 2017<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-37.pdf" data-entity-type="media" data-entity-uuid="a99aea54-0a87-478b-a796-4260ce7e1efc" data-entity-substitution="canonical" title="FAQs Part 37">Affordable Care Act Implementation FAQs (Set 37) (PDF)</a><br>This set of FAQs addresses health reimbursement arrangements and Code section 162(m)(6).</li><li>June 16, 2017<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-part-38.pdf" data-entity-type="media" data-entity-uuid="7c40b06c-992d-4792-8d2c-4cbd8e7b6038" data-entity-substitution="canonical" type="application/pdf" title="Affordable Care Act Implementation FAQs (Set 38)"><span class="mceNonEditable rx_inlinevariant">Affordable Care Act Implementation FAQs (Set 38) (PDF)</span></a><span class="mceNonEditable rx_inlinevariant"> </span> <br>This set of FAQs addresses the Mental Health Parity and Addiction Equity Act and the 21st Century Cures Act. Related information: <a href="/cciio/resources/forms-reports-and-other-resources/downloads/model-form-to-request-mh-sud-treatment-limitation-information.pdf" data-entity-type="media" data-entity-uuid="02193ebe-0c30-4fde-90d1-284f316b9085" data-entity-substitution="canonical" title="Draft Model Form to Request Documentation from an Employer-Sponsored Health Plan or an Insurer Concerning Treatment Limitations">Draft MHPAEA Disclosure Template (PDF)</a></li><li>April 23, 2018<br><a href="https://www.dol.gov/sites/dolgov/files/ebsa/about-ebsa/our-activities/resource-center/faqs/aca-part-39-proposed.pdf">Affordable Care Act Implementation FAQs (Proposed Set 39)</a><br>This proposed set of FAQs addresses the Mental Health Parity and Addiction Equity Act and the 21st Century Cures Act. Comments are requested by June 22, 2018.</li><li>August 23, 2019<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-40.pdf" data-entity-type="media" data-entity-uuid="917a38dd-7477-4854-9e27-3ba79f352881" data-entity-substitution="canonical" title="FAQs-Part-40">Affordable Care Act Implementation FAQs (Set 40) (PDF)</a><br>This set of FAQs addresses limitations on cost-sharing under the ACA.</li><li>September 5, 2019<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-39.pdf" data-entity-type="media" data-entity-uuid="9a5b7f27-fc16-4459-b775-7a76e0409b51" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs (Set 39)">Affordable Care Act Implementation FAQs (Final Set 39) (PDF)</a><br>This set of FAQs addresses the Mental Health Parity and Addiction Equity Act and the 21st Century Cures Act. Related information: <span class="mceNonEditable rx_inlinevariant"> </span><a href="/cciio/resources/fact-sheets-and-faqs/downloads/mhpaea-disclosure-template.docx" data-entity-type="media" data-entity-uuid="85aaf7de-669b-432e-a183-9b3b55a4964b" data-entity-substitution="canonical" type="application/vnd.openxmlformats-officedocument.wordprocessingml.document" title="MHPAEA Disclosure Template"><span class="mceNonEditable rx_inlinevariant">MHPAEA Disclosure Template (DOCX)</span></a><span class="mceNonEditable rx_inlinevariant"> </span>  <a href="/cciio/resources/fact-sheets-and-faqs/downloads/mhpaea-disclosure-template-1.pdf" data-entity-type="media" data-entity-uuid="b2427b54-19de-4464-9cfd-1bb8be005963" data-entity-substitution="canonical" type="application/pdf" title="MHPAEA-Disclosure-Template.pdf"><span class="mceNonEditable rx_inlinevariant">(PDF)</span> (PDF)</a><span class="mceNonEditable rx_inlinevariant"> </span> </li><li>February 3, 2020<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-41.pdf" data-entity-type="media" data-entity-uuid="536f1d0f-cbd0-434d-a55a-0dd14dd599fc" data-entity-substitution="canonical" title="tri-deptfaqs-aca-implementationfaqs-set41-01-2020.pdf">Affordable Care Act Implementation FAQs (Set 41) (PDF)</a><br>This set of FAQs addresses the Summary of Benefits and Coverage (SBC).</li><li><span>April 11, 2020</span><br><a href="/files/document/ffcra-part-42-faqs.pdf" data-entity-type="media" data-entity-uuid="58f18615-661d-45da-b4f9-734df4819003" data-entity-substitution="canonical" title="FFCRA-Part-42-FAQs"><span>Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation FAQs (Set 42)</span> (PDF)</a><br><span>This set of FAQs addresses the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act, and other topics related to COVID-19, including notice requirements, excepted benefits, and telehealth and other remote care services.</span></li><li><span>June 23, 2020</span><br><a href="/files/document/ffcra-part-43-faqs.pdf" data-entity-type="media" data-entity-uuid="bdc25041-03dc-4f6a-ba76-35bfd5669bbe" data-entity-substitution="canonical" title="FFCRA-Part-43-FAQs"><span>Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation FAQs (Set 43)</span> (PDF)</a><br><span>This set of FAQs addresses the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act, and other topics related to COVID-19, including notice requirements, telehealth, and other remote care services, grandfathered health plans, the Mental Health Parity and Addiction Equity Act, wellness programs, and individual coverage health reimbursement arrangements. </span><br><span>*Some of the guidance in FAQs Set 43 has been superseded by guidance contained in FAQs Set 51.</span></li><li><span>February 26, 2021</span><br><a href="/files/document/faqs-part-44.pdf" data-entity-type="media" data-entity-uuid="ab582e2e-3eba-43a6-998a-7eb49795fbb8" data-entity-substitution="canonical" title="FAQs-Part-44"><span>Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation FAQs (Set 44) (PDF)</span></a><span> </span><br><span>This set of FAQs addresses the Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act, and other topics related to COVID-19, including notice requirements, excepted benefits, and the provider relief fund.</span><br><span>* Some of the guidance in FAQs Set 44 has been superseded by guidance contained in FAQs Set 50. </span><br>** The Provider Relief Fund, described in Q14 in FAQs set 44, no longer accepts claims for testing, treatment, or COVID-19 vaccination.</li><li><span>April 2, 2021</span><br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/mhpaea-faqs-part-45.pdf" data-entity-type="media" data-entity-uuid="345045c8-9031-469f-9f01-9e884ae41089" data-entity-substitution="canonical" title="FAQs-Part-45"><span>Affordable Care Act Implementation FAQs (Set 45) (PDF)</span></a><br><span>This set of FAQs addresses the Mental Health Parity and Addiction Equity Act and the Consolidated Appropriations Act, 2021. </span></li><li><span>June 4, 2021</span><br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-46.pdf" data-entity-type="media" data-entity-uuid="94e39b05-6d8a-4d8a-9d0e-052f49a80051" data-entity-substitution="canonical" title="FAQs-Part-46"><span>Affordable Care Act Implementation FAQs (Set 46) (PDF)</span></a><br>This set of FAQs addresses limitations on cost-sharing under the ACA. </li><li><span>July 19, 2021</span><br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-47.pdf" data-entity-type="media" data-entity-uuid="5df68713-10a6-49f8-8ebf-39433090407d" data-entity-substitution="canonical" title="FAQs Part 47"><span>Affordable Care Act Implementation FAQs (Set 47) (PDF)</span></a><span> </span><br>This set of FAQs addresses coverage of preventive services.</li><li>August 16, 2021<br><a href="/files/document/faqs-part-48.pdf" data-entity-type="media" data-entity-uuid="c48f1fa8-8ad3-426d-a544-e82dfbf02d52" data-entity-substitution="canonical" title="FAQs Part 48">Affordable Care Act Implementation FAQs (Set 48) (PDF)</a> <br>This set of FAQs addresses coverage of preventive services</li><li>August 20, 2021<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-49.pdf" data-entity-type="media" data-entity-uuid="b43ac71e-9a2a-46dd-98b8-78e878859258" data-entity-substitution="canonical" title="FAQs About ACA & CAA Implementation Part 49_MM 508_08-20-21">Affordable Care Act Implementation FAQs (Set 49) (PDF)</a><br>This set of FAQs addresses implementation of the machine-readable files required under ACA price transparency provisions, internet-based self-service tool (or “price comparison tool”) under both ACA price transparency provisions and the Consolidated Appropriations Act, 2021 (CAA), and gag clause, provider directory, continuity of care, and pharmacy benefits and drug costs provisions of the CAA.<br>*Some of the guidance in FAQs Set 49 has been superseded by guidance contained in FAQs Set 61. This FAQ was updated on September 28, 2023, to include a link to FAQs Set 61.</li><li>October 4, 2021<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-50.pdf" data-entity-type="media" data-entity-uuid="b307650f-7dbf-4695-ba87-e3aac578df38" data-entity-substitution="canonical" title="FAQs-Part-50">Affordable Care Act Implementation FAQs (Set 50) (PDF)</a> <br><span>This set of FAQs addresses rapid coverage of preventive services for coronavirus and HIPAA nondiscrimination and wellness programs.</span></li><li>January 10, 2022<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-51.pdf" data-entity-type="media" data-entity-uuid="3b4f761a-4279-4b2f-8feb-568421e45eb0" data-entity-substitution="canonical" title="FAQs-Part-51">FAQs about Affordable Care Act Implementation, Families First Coronavirus Response Act, and Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 51) (PDF)</a><br><span>This set of FAQs addresses rapid coverage of COVID-19 diagnostic testing and coverage of preventive services. </span><br><span>*Some of the guidance in FAQs Set 51 has been superseded by guidance contained in FAQs Set 52.</span></li><li>February 4, 2022<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-52.pdf" data-entity-type="media" data-entity-uuid="465ffe0a-35a4-456d-ac69-780b1a383dd5" data-entity-substitution="canonical" title="aca-part-52">Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation FAQs (Set 52) (PDF)</a><br>This set of FAQs address coverage of COVID-19 diagnostic testing.</li><li>April 19, 2022<br><a href="/files/document/faqs-part-53.pdf" data-entity-type="media" data-entity-uuid="d3a6594b-9574-40ae-af46-6c1b7d9af513" data-entity-substitution="canonical" title="FAQs-Part-53">Affordable Care Act Implementation FAQs (Set 53) (PDF)</a><br>This set of FAQs addresses Transparency in Coverage machine-readable files. <br>*Some of the guidance in FAQs Set 53 has been superseded by guidance contained in FAQs Set 61. This FAQ was updated on September 28, 2023, to include a link to FAQs Set 61.</li><li>July 28, 2022<br><a href="/files/document/faqs-part-54.pdf" data-entity-type="media" data-entity-uuid="2b90ea66-e9a0-40cb-bd44-c049aa5d2191" data-entity-substitution="canonical" title="FAQs-Part-54">Affordable Care Act Implementation FAQs (Set 54) (PDF)</a><br>The set of FAQs addresses preventive services requirements for contraceptive coverage.</li><li>August 19, 2022<br><a href="/files/document/faqs-part-55.pdf" data-entity-type="media" data-entity-uuid="2541a087-ab2f-47d0-86bd-42167848b398" data-entity-substitution="canonical" title="FAQs-Part-55">FAQs about Affordable Care Act and Consolidated Appropriations Act, 2021 Implementation (Set 55) (PDF)</a><br>This set of FAQs addresses implementation of the No Surprises Act and Transparency in Coverage machine-readable files. <br>*Some of the guidance in FAQs Set 55 is affected by the decision in Texas Medical Association, et al. v. U.S. Department of Health and Human Services, et al., Case No. 6:22-cv-450-JDK (TMA III). See FAQs Set 62 and FAQs Set 67 for guidance on the relevant provisions in light of this court decision.</li><li>December 23, 2022<br><a href="/files/document/aca-part-56.pdf" data-entity-type="media" data-entity-uuid="52e44340-35a0-4e14-9422-b082cb44d123" data-entity-substitution="canonical" title="aca-part-56">FAQs about Affordable Care Act and Consolidated Appropriations Act, 2021 Implementation (Set 56) (PDF)</a><br>This set of FAQs addresses reporting of prescription drug and health care spending. </li><li>February 23, 2023<br><a href="/files/document/aca-part-57.pdf" data-entity-type="media" data-entity-uuid="0160d2ae-decf-4199-be36-ec4fc82e47a4" data-entity-substitution="canonical" title="aca-part-57">FAQs about Consolidated Appropriations Act, 2021 Gag Clause Implementation (Set 57) (PDF)</a> <br>This set of FAQs addresses the gag clause prohibition provisions, including the attestation requirement.</li><li>March 29, 2023<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-58.pdf" data-entity-type="media" data-entity-uuid="9d1acb04-2569-4443-8a24-1cfd240b97f4" data-entity-substitution="canonical" title="FAQs-Part-58">FAQs about Families First Coronavirus Response Act, Coronavirus Aid, Relief, and Economic Security Act and Health Insurance Portability and Accountability Act Implementation (Set 58) (PDF)</a>  <br>This set of FAQs addresses coverage of COVID-19 diagnostic testing, vaccines, extension of timeframes, and special enrollment periods.</li><li>April 13, 2023<br><a href="/files/document/faqs-part-59.pdf" data-entity-type="media" data-entity-uuid="93938ee2-adb6-4d3d-ae4a-7cc6288fe059" data-entity-substitution="canonical" title="FAQs-Part-59">FAQs about Affordable Care Act and Coronavirus Aid, Relief, and Economic Security Act Implementation (Set 59) (PDF)</a><br>This set of FAQs addresses coverage of preventive services in light of the court decision in Braidwood Management Inc. v. Becerra.</li><li>July 7, 2023<br><a href="/files/document/faqs-part-60.pdf" data-entity-type="media" data-entity-uuid="90c7e4ec-6822-4348-ae10-caec884fa214" data-entity-substitution="canonical" title="FAQs Part 60">FAQs about Affordable Care Act and Consolidated Appropriations Act, 2021 Implementation (Set 60) (PDF)</a><br>This set of FAQs addresses the No Surprises Act, limitations on cost sharing under the ACA, and transparency in coverage with regard to facility fees under the ACA and the No Surprises Act.</li><li>September 27, 2023<br><a href="/files/document/faqs-about-affordable-care-act-implementation-part-61.pdf" data-entity-type="media" data-entity-uuid="6d8dc7f5-b978-43ca-9dfb-1621c984512f" data-entity-substitution="canonical" title="FAQs about Affordable Care Act Implementation Part 61">Affordable Care Act Implementation (Set 61) (PDF)</a><br>This set of FAQs addresses the Transparency in Coverage rules.</li><li>October 6, 2023<br><a href="/files/document/faqs-part-62.pdf" data-entity-type="media" data-entity-uuid="943bb0b3-a424-419d-8ae2-e796f101b0e1" data-entity-substitution="canonical" title="FAQs-part-62">FAQs about Consolidated Appropriations Act, 2021 Implementation (Set 62) (PDF)</a><br>This set of FAQs addresses implementation of the No Surprises Act in light of the court decision in Texas Medical Association et al. v. U.S. Department of Health and Human Services et al. (TMA III).<br>*Some of the guidance in FAQs Set 62 has been superseded by guidance contained in FAQs Set 67.</li><li>November 28, 2023<br><a href="/files/document/faqs-part-63.pdf" data-entity-type="media" data-entity-uuid="c315e78c-b5d6-4932-90ad-3de66d0b5b22" data-entity-substitution="canonical" title="faqs part 63">FAQs about Affordable Care Act and Consolidated Appropriations Act, 2021 Implementation (Set 63) (PDF)</a><br>This set of FAQs addresses the Culturally and Linguistically Appropriate Services (CLAS) County Data and the No Surprises Act.</li><li>January 22, 2024<br><a href="/files/document/faqs-part-64.pdf" data-entity-type="media" data-entity-uuid="4df005a9-39fe-448e-9287-e898dd1117cd" data-entity-substitution="canonical" title="faqs-part-64">Affordable Care Act Implementation FAQs (Set 64) (PDF)</a><br>This set of FAQs addresses the preventive services requirements for contraceptive coverage.</li><li>February 2, 2024<br><a href="/files/document/faq-about-affordable-care-act-implementation-part-65.pdf" data-entity-type="media" data-entity-uuid="5705b100-4c68-4107-a9b7-554e614f3743" data-entity-substitution="canonical" title="faq-about-affordable-care-act-implementation-part-65">Affordable Care Act Implementation (Set 65) (PDF)</a><br>This set of FAQs addresses Transparency in Coverage rules.</li><li>April 2, 2024<br><a href="/files/document/aca-part-66.pdf-0" data-entity-type="media" data-entity-uuid="f5297ca7-2afa-4fab-9572-6e3b015905a8" data-entity-substitution="canonical" title="aca-part-66">Affordable Care Act Implementation FAQs (Set 66) (PDF)</a><br>This set of FAQs addresses the prohibition on lifetime and annual limits and the annual limitation on cost sharing under the ACA.</li><li>May 1, 2024<br><a href="/files/document/faqs-part-67.pdf" data-entity-type="media" data-entity-uuid="710b79a2-ec66-4d24-bbdf-9ee3d04af14f" data-entity-substitution="canonical" title="FAQs Part 67">FAQ about Consolidated Appropriations Act, 2021 Implementation (Set 67) (PDF)</a><br>This set of FAQs addresses implementation of the No Surprises Act in light of the court decision in Texas Medical Association et al. v. U.S. Department of Health an Human Services et al. (TMA III).</li><li>October 21, 2024<br><a href="/files/document/faqs-implementation-part-68.pdf" data-entity-type="media" data-entity-uuid="9aad498c-93c1-4e8e-b237-0dc98e81ccc4" data-entity-substitution="canonical" title="FAQS IMPLEMENTATION PART 68">FAQs about Affordable Care Act and Women’s Health and Cancer Rights Act Implementation (Set 68) (PDF)</a> <br>This set of FAQs addresses coverage of preventive services under the Affordable Care Act and coverage requirements under the Women's Health and Cancer Rights Act.</li></ul><h2><a class="ck-anchor" id="Consumer_Support_and_Information"></a>Consumer Support and Information</h2><h3><a class="ck-anchor" id="Consumer_Assistance_Program_Grants"></a>Consumer Assistance Program Grants </h3><p><strong>Fact Sheets</strong></p><ul><li>November 21, 2011<br><a href="/CCIIO/Resources/Files/Downloads/cap_exchange_funding_memo.pdf">State Consumer Assistance Program Participation in Exchange Core Area 10 (PDF)</a></li><li>June 22, 2012<br><a href="/cciio/programs-and-initiatives/consumer-support-and-information/ltdfacts" data-entity-type="node" data-entity-uuid="2636bf3c-6119-49a8-a33f-e49dbbb5a52c" data-entity-substitution="canonical" title="New Funding Opportunity for Consumer Assistance Programs">New Funding Opportunity for Consumer Assistance Programs</a></li><li>August 24, 2012<br><a href="/cciio/resources/grants/cap-grants" data-entity-type="node" data-entity-uuid="f995166b-7f94-41a9-b615-885f0abefb3d" data-entity-substitution="canonical" title="Consumer Assistance Program Grants: Helping States Give Consumers Greater Control of their Health Care">Consumer Assistance Program Grants: Helping States Give Consumers Greater Control of their Health Care</a></li><li>August 24, 2012<br><a href="/cciio/resources/grants/cap-grants-states" data-entity-type="node" data-entity-uuid="62532013-4b6c-4e4b-b0ec-12d9bda9c8f2" data-entity-substitution="canonical" title="Consumer Assistance Program Grants: How States Are Using New Resource to Give Consumers Greater Control of Their Health Care">Consumer Assistance Program Grants: How States Are Using New Resource to Give Consumers Greater Control of their Health Care</a></li></ul><p><strong>FAQs</strong></p><ul><li>April 20, 2012<br><a href="/cciio/programs-and-initiatives/consumer-support-and-information/ltdfaq" data-entity-type="node" data-entity-uuid="debee590-117b-4430-9eab-96c2130a839e" data-entity-substitution="canonical" title="CAP Limited Competition Funding Opportunity Announcement">CAP Limited Competition Funding Opportunity Announcement</a></li><li>June 7, 2012<br><a href="/cciio/programs-and-initiatives/consumer-support-and-information/faq" data-entity-type="node" data-entity-uuid="d1d24411-599d-4a7f-9f02-e669c975c364" data-entity-substitution="canonical" title="Frequently Asked Questions about the CAP Grant Opportunity">New Consumer Assistance Programs Funding Opportunity for all States and Territories</a></li><li>September 26, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/final-cap-limited-foa-external-faq-08-13-2014.pdf" data-entity-type="media" data-entity-uuid="80a9583d-215e-42f4-9f97-e1c5e611848e" data-entity-substitution="canonical" title="CAP Limited Competition Funding Opportunity Announcement">CAP Limited Competition Funding Opportunity Announcement (PDF)</a>  </li></ul><h3><a class="ck-anchor" id="External_Appeals"></a>External Appeals</h3><p><strong>Fact Sheets</strong></p><ul><li>June 22, 2011<br><a href="/cciio/resources/files/working_with_states_to_protect_consumers_06222011" data-entity-type="node" data-entity-uuid="68a83cd5-aa4a-4f5a-bc08-8fe35f8b41e2" data-entity-substitution="canonical" title="Affordable Care Act: Working with States to Protect Consumers">Affordable Care Act: Working with States to Protect Consumers</a></li><li>June 19, 2012<br><a href="/cciio/programs-and-initiatives/consumer-support-and-information/csg-ext-appeals-facts" data-entity-type="node" data-entity-uuid="16eae6e3-51f8-4942-8d28-490c8556aefe" data-entity-substitution="canonical" title="HHS-Administered Federal External Review Process for Health Insurance Coverage">HHS-Administered Federal External Review Process</a></li><li>July 24, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/2013-clas-data.pdf" data-entity-type="media" data-entity-uuid="c9d7771f-89a9-4ee3-a114-179bc0c92a24" data-entity-substitution="canonical" title="2013 County Data for Culturally and Linguistically Appropriate Services">2013 County Data for Culturally and Linguistically Appropriate Services (PDF)</a><br>This Fact Sheet provides data so that group health plans and health insurance issuers offering non-grandfathered health coverage can determine the counties in which they are required to provide notices related to a consumer’s right to external review in a culturally and linguistically appropriate manner.</li><li>December 12, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/2009-13-clas-county-data.pdf" data-entity-type="media" data-entity-uuid="81b50f26-38ca-4c3d-816c-566fbc757bdc" data-entity-substitution="canonical" title="2009-13 CLAS County Data">Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF) </a>*Updated January 7, 2015</li><li>January 27, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/clas-county-data_jan-2016-update-final.pdf" data-entity-type="media" data-entity-uuid="66faa470-edef-443f-bbd6-99009572bbf6" data-entity-substitution="canonical" title="CLAS County Data_Jan 2016 update FINAL">Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF) - </a>for plan years (in the individual market, policy years) beginning prior to January 1, 2025</li><li>November 28, 2023<br><a href="/files/document/clas-county-data-2023.pdf" data-entity-type="media" data-entity-uuid="3371282e-2905-4a18-b03c-a7e1049edace" data-entity-substitution="canonical" title="CLAS county data 2023">Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF) - </a>for plan years (in the individual market, policy years) beginning on or after January 1, 2025     </li></ul><h3><a class="ck-anchor" id="Summary_of_Benefits_and_Coverage_and_Uniform_Glossary"></a>Summary of Benefits and Coverage and Uniform Glossary</h3><p><strong>Fact Sheets</strong></p><ul><li>August 17, 2011<br><a href="/cciio/resources/fact-sheets-and-faqs/labels08172011a" data-entity-type="node" data-entity-uuid="3234a465-2768-465c-8daf-a5fb9e02a85e" data-entity-substitution="canonical" title="Providing Clear and Consistent Information to Consumers About Their Health Insurance Coverage">Providing Clear and Consistent Information to Consumers about Their Health Insurance Coverage</a></li><li>July 24, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/2013-clas-data.pdf" data-entity-type="media" data-entity-uuid="c9d7771f-89a9-4ee3-a114-179bc0c92a24" data-entity-substitution="canonical" title="2013 County Data for Culturally and Linguistically Appropriate Services">2013 County Data for Culturally and Linguistically Appropriate Services (PDF)</a><br>This Fact Sheet provides data so that group health plans and health insurance issuers offering health coverage can determine the counties in which they are required to provide the summary of benefits and coverage in a culturally and linguistically appropriate manner.</li><li>December 12, 2104<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/2009-13-clas-county-data-01-07-15-508.pdf" data-entity-type="media" data-entity-uuid="facc390b-50c1-43d7-8cd7-57546b6a4176" data-entity-substitution="canonical" title="Culturally and Linguistically Appropriate Services (CLAS) County Data">Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF)</a>*<br>*Updated January 7, 2015</li><li>December 22, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/sbc-proposed-rule-fact-sheet-12-22-14.pdf" data-entity-type="media" data-entity-uuid="f0502f32-a300-43ff-8f63-cef27a842a23" data-entity-substitution="canonical" title="SBC Proposed Rule Fact Sheet 12 22 14">Proposed Summary of Benefits and Coverage and Uniform Glossary Rules (PDF)</a></li><li>June 12, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/fact-sheet_sbcfinalrule-6-11-15-mm-508.pdf" data-entity-type="media" data-entity-uuid="29c2a5f8-0e52-4431-8b4e-9643e3e30769" data-entity-substitution="canonical" title="Fact Sheet_SBCFinalRule 6-11-15 MM 508">Summary of Benefits and Coverage and Uniform Glossary Final Rule (PDF)</a></li><li>January 27, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/clas-county-data_jan-2016-update-final.pdf" data-entity-type="media" data-entity-uuid="66faa470-edef-443f-bbd6-99009572bbf6" data-entity-substitution="canonical" title="CLAS County Data_Jan 2016 update FINAL">Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF) - </a>for plan years (in the individual market, policy years) beginning prior to January 1, 2025.</li><li>November 28, 2023<br><a href="/files/document/clas-county-data-2023.pdf" data-entity-type="media" data-entity-uuid="3371282e-2905-4a18-b03c-a7e1049edace" data-entity-substitution="canonical" title="CLAS county data 2023">Culturally and Linguistically Appropriate Services (CLAS) County Data (PDF) - </a>for plan years (in the individual market, policy years) beginning on or after January 1, 2025.</li></ul><p><strong>FAQs</strong></p><ul><li>September 8, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/sbcpolicycertificatecovfaqs.pdf" data-entity-type="media" data-entity-uuid="8dd7cce6-1894-44c1-81c8-b49470cac558" data-entity-substitution="canonical" title="SBCPolicyCertificateCovFAQs">SBC Online Posting of Policy and Certificate of Coverage (PDF)</a></li><li>March 11, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/sbc-faq-final-3-11-16.pdf" data-entity-type="media" data-entity-uuid="bdda555b-b587-43a6-8041-285b7f6f780e" data-entity-substitution="canonical" title="SBC FAQ Final 3 11 16">FAQs Regarding the Summary of Benefits and Coverage (SBC) Related to Rate Filing and QHP Certification (PDF)</a></li><li>July 8, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/sbc-faqs-07072016-final-mm-508.pdf" data-entity-type="media" data-entity-uuid="eb00e769-3f7d-430f-9ab0-e0971a010bf0" data-entity-substitution="canonical" title="SBC FAQs 07072016 final MM 508">FAQs on the Summary of Benefit and Coverage Applicability Date (PDF)</a></li><li>February 3, 2020<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/sbc-faq-1-2020.pdf" data-entity-type="media" data-entity-uuid="4e83bb82-1493-49d8-918a-7d4c8165a691" data-entity-substitution="canonical" title="hhs_external_faq_on_sbc_calculator_updates-01-2020.pdf">FAQs on the Applicability Date of the Updated Summary of Benefits and Coverage Template, Calculator, and Related Materials (PDF)</a></li></ul><h3><a class="ck-anchor" id="Outreach_and_Education_Resources"></a>Outreach and Education Resources</h3><ul><li>September 29, 2011</li></ul><p>Consumer Fact Sheets</p><ul><li> <ul><li>Adding Adult Children to Your Health Plan (PDF – <a href="/cciio/resources/files/downloads/adding_adult_children_to_your_health_plan_04072011.pdf" data-entity-type="media" data-entity-uuid="65cc9c70-e2c7-4612-9847-324b69d09d68" data-entity-substitution="canonical" title="adding_adult_children_to_your_health_plan_04072011">English 178 KB (PDF)</a>, <a href="/cciio/resources/files/downloads/adding_adult_children_to_your_health_plan_04072011_spanish.pdf" data-entity-type="media" data-entity-uuid="96ec34f0-22b8-4802-85ae-2d78efc664ba" data-entity-substitution="canonical" title="adding_adult_children_to_your_health_plan_04072011_spanish">Spanish 89 KB (PDF)</a>)</li><li>Curbing Insurance Cancellations (PDF – <a href="/cciio/resources/files/downloads/curbing_insurance_cancellations_04072011.pdf" data-entity-type="media" data-entity-uuid="26434ad9-1328-4b3d-9a76-b3ea3693cd2c" data-entity-substitution="canonical" title="curbing_insurance_cancellations_04072011">English 170 KB (PDF)</a>, <a href="/cciio/resources/files/downloads/curbing_insurance_cancellations_04072011_spanish.pdf" data-entity-type="media" data-entity-uuid="c3a75e71-7737-4222-afa1-f42e23fe275a" data-entity-substitution="canonical" title="curbing_insurance_cancellations_04072011_spanish">Spanish 63 KB (PDF)</a>)</li><li>Eliminating Dollar Limits on Your Benefits (PDF – <a href="/cciio/resources/files/downloads/eliminating_dollar_limits_on_your_benefits_04072011.pdf" data-entity-type="media" data-entity-uuid="acfd8ec1-36dd-4002-840f-1ff647ce7c69" data-entity-substitution="canonical" title="eliminating_dollar_limits_on_your_benefits_04072011">English 184 KB (PDF)</a>, <a href="/cciio/resources/files/downloads/eliminating_dollar_limits_on_your_benefits_04072011_spanish.pdf" data-entity-type="media" data-entity-uuid="ea3db8d0-b341-4f95-81c9-c140b954564f" data-entity-substitution="canonical" title="eliminating_dollar_limits_on_your_benefits_04072011_spanish">Spanish 104 KB (PDF)</a>)</li><li>Getting Value for Your Premium Dollar (PDF –<a href="/cciio/resources/files/downloads/getting_value_for_your_premium_dollar_04072011.pdf" data-entity-type="media" data-entity-uuid="b57280b6-d6ec-47e6-a1a9-8c7c5e0d2f81" data-entity-substitution="canonical" title="getting_value_for_your_premium_dollar_04072011"> English 172 KB (PDF)</a>, <a href="/cciio/resources/files/downloads/getting_value_for_your_premium_dollar_04072011_spanish.pdf" data-entity-type="media" data-entity-uuid="e9e46057-1a2d-40b5-9f09-6ce9208e7c2b" data-entity-substitution="canonical" title="getting_value_for_your_premium_dollar_04072011_spanish">Spanish 104 KB (PDF)</a>)</li><li>Lowering Your Cost for Preventive Services (PDF – <a href="/cciio/resources/files/downloads/lowering_your_cost_for_preventive_services_04072011.pdf" data-entity-type="media" data-entity-uuid="e0b2af76-51d0-4833-b00a-3f5946a66f6a" data-entity-substitution="canonical" title="lowering_your_cost_for_preventive_services_04072011">English 353 KB (PDF)</a>, <a href="/cciio/resources/files/downloads/lowering_your_cost_for_preventive_services_04072011_spanish.pdf" data-entity-type="media" data-entity-uuid="174fcd1f-80d0-48e8-97a3-efb110626260" data-entity-substitution="canonical" title="lowering_your_cost_for_preventive_services_04072011_spanish">Spanish 111 KB (PDF)</a>)</li><li>Protecting Children With Pre-Existing Health Conditions (PDF – <a href="/cciio/resources/files/downloads/protecting_children_with_pre_existing_conditions_04072011.pdf" data-entity-type="media" data-entity-uuid="bdcfbcae-6281-45b3-ae3b-597f585838c6" data-entity-substitution="canonical" title="protecting_children_with_pre_existing_conditions_04072011">English 252 KB (PDF)</a>, <a href="/cciio/resources/files/downloads/protecting_children_with_pre_existing_conditions_04072011_spanish.pdf" data-entity-type="media" data-entity-uuid="ac967fc0-cc87-4114-8065-870fb1ae29cb" data-entity-substitution="canonical" title="protecting_children_with_pre_existing_conditions_04072011_spanish">Spanish 450 KB (PDF)</a>)</li><li>Protecting Your Choice of Health Care Providers (PDF – <a href="/cciio/resources/files/downloads/protecting_your_choice_of_health_care_providers_04072011.pdf" data-entity-type="media" data-entity-uuid="b0d6315d-a481-402f-9d8f-8428b6ae43f2" data-entity-substitution="canonical" title="protecting_your_choice_of_health_care_providers_04072011">English 219 KB (PDF)</a>, <a href="/cciio/resources/files/downloads/protecting_your_choice_of_health_care_providers_04072011_spanish.pdf" data-entity-type="media" data-entity-uuid="b24c0931-8e4d-4110-aac5-c83fb548b923" data-entity-substitution="canonical" title="protecting_your_choice_of_health_care_providers_04072011_spanish">Spanish 94 KB (PDF)</a>)</li><li>Are You in a Grandfathered Health Plan (PDF – <a href="/cciio/resources/files/downloads/are_you_in_a_grandfathered_health_plan_04072011.pdf" data-entity-type="media" data-entity-uuid="7aecc7c1-af69-4091-b502-b87f2085d1b7" data-entity-substitution="canonical" title="are_you_in_a_grandfathered_health_plan_04072011">English 307 KB (PDF)</a>, <a href="/cciio/resources/files/downloads/are_you_in_a_grandfathered_health_plan_06012011_spanish.pdf" data-entity-type="media" data-entity-uuid="d9eb1108-5803-4678-ba19-b2696390ad1b" data-entity-substitution="canonical" title="are_you_in_a_grandfathered_health_plan_06012011_spanish">Spanish 57 KB (PDF)</a>)</li><li>Putting the Brakes on Unreasonable Health Insurance Rate Increases (PDF - <a href="/cciio/resources/files/downloads/rate_review_fact-_sheet10192011_508.pdf" data-entity-type="media" data-entity-uuid="5ea50f14-43de-4d29-944b-1322a2581108" data-entity-substitution="canonical" title="rate_review_fact _sheet10192011_508">English 77 KB (PDF)</a>, <a href="/cciio/resources/files/downloads/spanish_rate_revewi_fact_sheet_508.pdf" data-entity-type="media" data-entity-uuid="0ab42991-e7ff-4401-801f-f917251a54a1" data-entity-substitution="canonical" title="spanish_rate_revewi_fact_sheet_508">Spanish 63 KB (PDF)</a>)</li></ul></li><li>April 7, 2011</li></ul><p>Consumer Posters and Brochures</p><ul><li> <ul><li>State Consumer Assistance Poster (PDF – <a href="/cciio/resources/files/downloads/state_consumer_assistance_poster_04072011.pdf" data-entity-type="media" data-entity-uuid="92c6fab0-25c5-44e6-850c-150fcdb7e131" data-entity-substitution="canonical" title="state_consumer_assistance_poster_04072011">English 1 MB (PDF)</a>, <a href="/cciio/resources/files/downloads/state_consumer_assistance_poster_spanish_04072011.pdf" data-entity-type="media" data-entity-uuid="9445496b-c03d-41ea-b402-f83108329c9c" data-entity-substitution="canonical" title="state_consumer_assistance_poster_spanish_04072011">Spanish 884 KB (PDF)</a>)</li><li><a href="/cciio/resources/files/downloads/state_consumer_assistance_brochure_04072011.pdf" data-entity-type="media" data-entity-uuid="fc0d26ee-3e9e-4520-a648-8d24970cc8cf" data-entity-substitution="canonical" title="state_consumer_assistance_brochure_04072011">State Consumer Assistance Brochure (PDF – 2 MB) (PDF)</a></li></ul></li></ul><h2><a class="ck-anchor" id="Taglines"></a>Language Access Taglines for Exchanges, Qualified Health Plan (QHP) Issuers, and Web-Brokers</h2><p><strong>FAQs</strong></p><ul><li>August 10,2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/tagline-faqs-7-27-16-clean-letterhead-mm-508.pdf" data-entity-type="media" data-entity-uuid="34554896-cbc1-4912-abb2-b6f39f23d633" data-entity-substitution="canonical" title="Tagline-FAQs-7-27-16-clean-letterhead-MM-508">Language Access Tagline Frequently Asked Questions (PDF)</a></li></ul><h2><a class="ck-anchor" id="Content_Requirements_for_Plan_Finder"></a>Content Requirements for Plan Finder</h2><p><strong>Fact Sheets:</strong></p><ul><li>May 1, 2011<br><a href="/cciio/resources/files/downloads/establishing_web_portal_fact_sheet_05012011.pdf" data-entity-type="media" data-entity-uuid="68040b9e-76d2-4d82-8850-ee5278d3eb99" data-entity-substitution="canonical" title="establishing_web_portal_fact_sheet_05012011">Establishing the Web Portal Called For in the Affordable Care Act (PDF – 115 KB) (PDF)</a></li></ul><h2><a class="ck-anchor" id="Pre-Existing Condition Insurance Plan (PCIP)"></a>Pre-Existing Condition Insurance Plan (PCIP)</h2><p><strong>Fact Sheets</strong></p><ul><li>July 29, 2010<br><a href="/cciio/resources/fact-sheets-and-faqs/preexistingconditioninsuranceplan" data-entity-type="node" data-entity-uuid="37de73e7-ae53-439d-b9e9-8a5460125602" data-entity-substitution="canonical" title="About the New Pre-Existing Condition Insurance Plan">About the New Pre-Existing Condition Insurance Plan</a></li><li>February 14, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/pcip-enrollment" data-entity-type="node" data-entity-uuid="e1497177-d31f-4288-9d9b-39d83269dccb" data-entity-substitution="canonical" title="State by State Enrollment in the Pre-Existing Condition Insurance Plan">State by State Enrollment in the Pre-Existing Condition Insurance Plan</a></li><li>April 24, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/pcip-fact-sheet-4-24-2014.pdf" data-entity-type="media" data-entity-uuid="879967fb-35ac-43a2-9792-69e2dade35c8" data-entity-substitution="canonical" title="Special Enrollment Period for Individuals Losing Coverage through the Pre-Existing Condition Insurance Program (PCIP) on April 30 2014">Special Enrollment Period for Individuals Losing Coverage through the Pre-Existing Condition Insurance Program (PCIP) on April 30, 2014 (PDF)</a></li></ul><p><strong>FAQs</strong></p><ul><li>May 8, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/pcip-state-contracts-and-extension" data-entity-type="node" data-entity-uuid="d2b6105a-4b80-479a-8825-fe946c18de2e" data-entity-substitution="canonical" title="PCIP State Contracts and Extension ">PCIP State Contracts and Extension</a></li></ul><h2><a class="ck-anchor" id="Health_Insurance_Marketplaces"></a>Health Insurance Marketplaces</h2><p><strong>Fact Sheets</strong></p><ul><li>January 13, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/state-marketplaces" data-entity-type="node" data-entity-uuid="58b65606-e703-4315-9942-a8fadb5b9f0d" data-entity-substitution="canonical" title="State-based Exchanges">State Health Insurance Marketplaces (List of Conditionally Approved Exchanges)</a></li><li>May 31, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/ffe" data-entity-type="node" data-entity-uuid="d9a8c1dd-c359-4c6e-ad53-2be70a8b9738" data-entity-substitution="canonical" title="Federal Marketplace Progress Fact Sheet">Progress Continues in Building Exchanges</a><br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/marketplace-timeline.pdf" data-entity-type="media" data-entity-uuid="ce7ee2a1-38d2-4164-8d23-fd4787b26dbd" data-entity-substitution="canonical" title="marketplace-timeline">Marketplace Timeline (PDF - 240 KB) (PDF)</a><br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/marketplace-timeline-narrative.pdf" data-entity-type="media" data-entity-uuid="7dba56bb-c728-41a5-b907-c809895c5bd6" data-entity-substitution="canonical" title="marketplace-timeline-narrative">Narrative Description of Marketplace Timeline (PDF - 204 KB) (PDF)</a></li><li>June 14, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/pi-nprm-6-14-2013" data-entity-type="node" data-entity-uuid="91ec82c6-fb21-42d9-a7af-e7ea22ecc73a" data-entity-substitution="canonical" title="Program Integrity Proposed Rule">Notice of Proposed Rulemaking on Program Integrity</a></li><li>June 24, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/marketplace-outreach-timeline.pdf" data-entity-type="media" data-entity-uuid="dc75ace2-df72-48e3-aa13-331db3762946" data-entity-substitution="canonical" type="application/pdf" title="Marketplace Outreach Timeline"><span class="mceNonEditable rx_inlinevariant">Marketplace Outreach Timeline (PDF)</span></a></li><li>June 26, 2013<br><a href="https://wcms.cms.gov:9009/Rhythmyx/assembler/render?sys_revision=2&sys_context=0&sys_authtype=0&sys_variantid=878&sys_contentid=166837">HHS Final Rule and Treasury Notices on Individual Shared Responsibility Provision Exemptions, Minimum Essential Coverage, and Related Topics</a></li><li>July 5, 2013<br><a href="https://wcms.cms.gov:9009/Rhythmyx/assembler/render?sys_revision=3&sys_context=0&sys_authtype=0&sys_variantid=878&sys_contentid=167142">Eligibility Final Rule: Strengthening Medicaid, The Children’s Health Insurance Program and The New Health Insurance Marketplace</a></li><li>August 28, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/pi-final-8-28-2013" data-entity-type="node" data-entity-uuid="91dd4f18-51da-4c42-8db7-3ce9ef168bc0" data-entity-substitution="canonical" title="Program Integrity Rule">Program Integrity Rule: Exchanges, SHOP, Eligibility Appeals: Safeguarding Federal Funds and Furthering Consumer Protection</a></li><li>October 24, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/pi-final-10-24-2013" data-entity-type="node" data-entity-uuid="3f1245f0-b80e-4630-9d8e-b49c38097d5c" data-entity-substitution="canonical" title="Program Integrity Rule">Program Integrity Rule: Exchanges, Premium Stabilization Programs and Market Standards; Amendments to the HHS Notice of Benefit and Payment Parameters for 2014</a></li><li>May 6, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/ifc-fact-sheet-final-5-6-16.pdf" data-entity-type="media" data-entity-uuid="382eb354-a5c5-438b-ab84-c5424093d6a7" data-entity-substitution="canonical" title="IFC Fact Sheet FINAL 5-6-16">Special Enrollment Periods and the Consumer Operated and Oriented Plan Program (PDF)</a></li><li>December 12, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/pre-enrollment-sep-fact-sheet-final.pdf" data-entity-type="media" data-entity-uuid="e81e972b-323d-477c-9aef-3213d62037a2" data-entity-substitution="canonical" title="Pre-Enrollment SEP fact sheet FINAL">Pre-Enrollment Verification for Special Enrollment Periods (PDF)</a></li><li>December 12, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/esrd-ifc-factsheet-final-2-12-12-16.pdf" data-entity-type="media" data-entity-uuid="7746b939-6b37-43d1-adee-14c8b9943b91" data-entity-substitution="canonical" title="ESRD-IFC-FactSheet-FINAL 2 12 12 16">Promoting Transparency and Appropriate Coverage for Dialysis Patients (PDF)</a></li><li>November 7, 2018<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/fact-sheetprogramintegrityproposed-final.pdf" data-entity-type="media" data-entity-uuid="232ab5e5-0f27-4570-ba94-9bf8368908a1" data-entity-substitution="canonical" title="Fact Sheet for Exchange Program Integrity Proposed Rule">Fact Sheet for Exchange Program Integrity Proposed Rule (PDF)</a></li></ul><p><strong>FAQs</strong></p><ul><li>November 29, 2011<br><a href="/cciio/resources/files/downloads/exchange_q_and_a.pdf" data-entity-type="media" data-entity-uuid="326334e3-b3fe-4967-a9ef-2811ff188a9e" data-entity-substitution="canonical" title="exchange_q_and_a">State Exchange Implementation Questions and Answers (PDF – 135 KB) (PDF)</a></li><li>December 10, 2012<br><a href="/cciio/resources/files/downloads/exchanges-faqs-12-10-2012.pdf" data-entity-type="media" data-entity-uuid="da68bcaf-f59f-4697-8163-6d65c3ade185" data-entity-substitution="canonical" title="exchanges-faqs-12-10-2012">Exchanges, Market Reforms and Medicaid Frequently Asked Questions (PDF - 356 KB) (PDF)</a></li><li>March 29, 2013<br><a href="/cciio/resources/files/downloads/ancillary-product-faq-03-29-2013.pdf" data-entity-type="media" data-entity-uuid="5ef960b6-e2aa-4360-8b10-30b4badee8a2" data-entity-substitution="canonical" title="ancillary-product-faq-03-29-2013">Frequently Asked Questions on Reuse of Exchange for Ancillary Products (PDF - 127 KB) (PDF)</a></li><li>May 14, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/marketplace-faq-5-14-2013.pdf" data-entity-type="media" data-entity-uuid="f5b2c3ea-99a1-4e71-9f64-fb7e5b8cb82e" data-entity-substitution="canonical" title="marketplace-faq-5-14-2013rev2">Frequently Asked Questions on Health Insurance Marketplaces (PDF – 86 KB) (PDF)</a></li><li>July 10, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/7_10_13-fee_assessment_faq_mc.pdf" data-entity-type="media" data-entity-uuid="80cf9c34-0dc5-4252-810f-44e98e6f8498" data-entity-substitution="canonical" title="Question and Answer on Assessment Fees Collected in a State-based Marketplace">Question and Answer on Assessment Fees Collected in a State-based Marketplace (PDF – 124 KB) (PDF)</a></li><li>August 5, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/income-verification-8-5-2013.pdf" data-entity-type="media" data-entity-uuid="89084d30-a7ac-4d06-ba4c-d0ff480df86f" data-entity-substitution="canonical" title="Question and Answer on Health Insurance Marketplaces and Income Verification">Question and Answer on Health Insurance Marketplaces and Income Verification (PDF – 104 KB) (PDF)</a></li><li>September 30, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/members-of-congress-faq-9-30-2013.pdf" data-entity-type="media" data-entity-uuid="b2615a90-9b9b-4e1d-9cf7-7e2136919d28" data-entity-substitution="canonical" type="application/pdf" title="Question and Answer on Members of Congress and Staff Accessing Coverage through Health Insurance Exchanges (Marketplaces)"><span class="mceNonEditable rx_inlinevariant">Question and Answer on Members of Congress and Staff Accessing Coverage through Health Insurance Exchanges (Marketplaces) (PDF)</span></a></li><li>October 28, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/enrollment-period-faq-10-28-2013.pdf" data-entity-type="media" data-entity-uuid="a7451821-f8d6-42b8-8d9d-6ceeec63a10d" data-entity-substitution="canonical" type="application/pdf" title="Question and Answer on Enrollment Period"><span class="mceNonEditable rx_inlinevariant">Question and Answer on Enrollment Period (PDF)</span></a></li><li>November 4, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/third-party-qa-11-04-2013.pdf" data-entity-type="media" data-entity-uuid="4fba916d-322b-4171-ada2-f192d22bc444" data-entity-substitution="canonical" type="application/pdf" title="Question and Answer on Third Party Payments of Premiums for Qualified Health Plans in the Marketplaces"><span class="mceNonEditable rx_inlinevariant">Question and Answer on Third Party Payments of Premiums for Qualified Health Plans in the Marketplaces (PDF)</span></a></li><li>December 13, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/csr-recon-methodology-qa-12-13-2013.pdf" data-entity-type="media" data-entity-uuid="a933f8ad-8124-4799-9138-4612ac40647c" data-entity-substitution="canonical" type="application/pdf" title="Question and Answer on Choice of Methodology for Cost-Sharing Reduction Reconciliation"><span class="mceNonEditable rx_inlinevariant">Question and Answer on Choice of Methodology for Cost-Sharing Reduction Reconciliation (PDF)</span></a></li><li>February 7, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/third-party-payments-of-premiums-for-qualified-health-plans-in-the-marketplaces-2-7-14.pdf" data-entity-type="media" data-entity-uuid="64eba176-fc58-4db2-9e6e-a98878af1c3f" data-entity-substitution="canonical" title="Third Party Payments of Premiums for Qualified Health Plans in the Marketplaces">Third Party Payments of Premiums for Qualified Health Plans in the Marketplaces (PDF)</a></li><li>February 21, 2014*<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/mcos-1-15-15.pdf" data-entity-type="media" data-entity-uuid="23b88b90-af2f-46a6-9242-39b68c530391" data-entity-substitution="canonical" title="Question and Answer on Medicaid Managed Care Contractors Outreach to Former Enrollees">Question and Answer on Medicaid Managed Care Contractors Outreach to Former Enrollees (PDF)</a><br>*Updated January 15, 2015</li><li>May 9, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/csrs_and_contract_health_services_qa.pdf" data-entity-type="media" data-entity-uuid="c39f8e05-d450-42da-a700-51802681ea71" data-entity-substitution="canonical" type="application/pdf" title="Question and Answer on Cost-Sharing Reductions for Contract Health Services"><span class="mceNonEditable rx_inlinevariant">Question and Answer on Cost-Sharing Reductions for Contract Health Services (PDF)</span></a></li><li>June 12, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-on-ecps-6-12-14.pdf" data-entity-type="media" data-entity-uuid="35addfd5-d8ab-44ef-9ca4-e75bc68cceee" data-entity-substitution="canonical" title="Frequently Asked Questions on Essential Community Providers (PDF – 106 KB)">Frequently Asked Questions on Essential Community Providers (PDF – 106 KB) (PDF)</a></li><li>June 1, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/sbm-shop-transitional-flexibility-faq-rev-5-29-2015.pdf" data-entity-type="media" data-entity-uuid="a5b4f89a-87c5-4b56-8767-a94e91c1079d" data-entity-substitution="canonical" title="Frequently Asked Questions on State-Based SHOP Direct Enrollment">Frequently Asked Questions on State-Based SHOP Direct Enrollment (PDF)</a></li><li>July 28, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/sbm-exemption-processing-faq-7-21-15.pdf" data-entity-type="media" data-entity-uuid="b3da7b6b-cbd7-448e-80bf-bdec81f1e11c" data-entity-substitution="canonical" title="Frequently Asked Questions on State-based Marketplace Options for Implementing Exemptions from the Shared Responsibility Payment">Frequently Asked Questions on State-based Marketplace Options for Implementing Exemptions from the Shared Responsibility Payment (PDF)</a></li><li>September 18, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/frequently-asked-questions-ab-shop-final-91815.pdf" data-entity-type="media" data-entity-uuid="065e0957-15af-4b74-bf56-3ae40ca74a27" data-entity-substitution="canonical" title="Frequently Asked Questions AB SHOP FINAL 9.18.15">Frequently Asked Questions Regarding Agents and Brokers Operating in the SHOP Marketplace (PDF)</a></li><li>September 18, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/employer-notice-faq-9-18-15.pdf" data-entity-type="media" data-entity-uuid="e26af670-464c-4ce4-8f4f-6cd94b151b94" data-entity-substitution="canonical" title="Frequently Asked Questions Regarding the Federally-Facilitated Marketplace’s (FFM) 2016 Employer Notice Program">Frequently Asked Questions Regarding the Federally-Facilitated Marketplace’s (FFM) 2016 Employer Notice Program (PDF)</a></li><li>October 23, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/mars-e-2-0-faq_final_102315.pdf" data-entity-type="media" data-entity-uuid="5a6ae7da-0a75-447b-b736-5b9a85a43dc9" data-entity-substitution="canonical" title="Frequently Asked Questions On The Applicability Of The Minimum Acceptable Risk Standards for Exchanges (MARS-E) 2.0 To Qualified Health Plan (QHP) Issuers">Frequently Asked Questions On The Applicability Of The Minimum Acceptable Risk Standards for Exchanges (MARS-E) 2.0 To Qualified Health Plan (QHP) Issuers (PDF)</a></li><li>May 3, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/incarceration-and-the-marketplace-faqs-05-03-2016.pdf" data-entity-type="media" data-entity-uuid="434aadfb-89ca-4b47-9bcb-feee4b3ae1eb" data-entity-substitution="canonical" title="Incarceration and the Marketplace FAQs 05 03 2016">Frequently Asked Questions on Incarceration and the Marketplace (PDF)</a></li><li>July 21, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/final-income-datamatching-faq-7-21-16.pdf" data-entity-type="media" data-entity-uuid="d6daed16-d62a-4785-91d3-df1d6309d452" data-entity-substitution="canonical" title="FINAL Income Datamatching FAQ 7.21.16">Frequently Asked Questions on Annual Income Threshold Adjustment (PDF)</a></li><li>July 19, 2017<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-operational-reviews.pdf" data-entity-type="media" data-entity-uuid="b7e7cfa7-2a21-45ef-9466-942292ed1834" data-entity-substitution="canonical" type="application/pdf" title="Frequently Asked Questions Regarding Third-party Auditor Operational Readiness Reviews for the Proxy Direct Enrollment Pathway"><span class="mceNonEditable rx_inlinevariant">Frequently Asked Questions Regarding Third-party Auditor Operational Readiness Reviews for the Proxy Direct Enrollment Pathway (PDF)</span></a><span class="mceNonEditable rx_inlinevariant"> </span> </li><li>June 20, 2018<br><a href="/cciio/programs-and-initiatives/health-insurance-marketplaces/downloads/faq-ede-spanish-translation-and-audit-requirements.pdf" data-entity-type="media" data-entity-uuid="922ef157-4f80-45da-b097-2acbf74fb893" data-entity-substitution="canonical" type="application/pdf" title="FAQs Regarding Spanish Translation and Audit Requirements for Enhanced Direct Enrollment (EDE) Entities Serving Consumers in States with FFEs"><span class="mceNonEditable rx_inlinevariant">FAQs Regarding Spanish Translation and Audit Requirements for Enhanced Direct Enrollment (EDE) Entities Serving Consumers in States with FFEs (PDF)</span></a><span class="mceNonEditable rx_inlinevariant"> </span> </li><li>November 21, 2018<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-on-providing-consumers-with-details-on-plan-coverage-of-certain-abortion-services.pdf" data-entity-type="media" data-entity-uuid="ee9a6064-7238-4eb3-9ddc-4ac5ecadacb2" data-entity-substitution="canonical" title="FAQ-on-Providing-Consumers-with-Details-on-Plan-Coverage-of-Certain-Abortion-Services">FAQs for Agents, Brokers and Assisters Providing Consumers with Details on Plan Coverage of Certain Abortion Services (PDF)</a></li><li>May 1, 2019<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/2019-faq-blueprint-for-exchanges.pdf" data-entity-type="media" data-entity-uuid="dbca2c1f-27ea-4a37-975b-b827b77c63dd" data-entity-substitution="canonical" type="application/pdf" title="2019 Frequently Asked Questions on the Blueprint for Exchanges"><span class="mceNonEditable rx_inlinevariant">2019 Frequently Asked Questions on the Blueprint for Exchanges (PDF)</span></a><span class="mceNonEditable rx_inlinevariant"> </span>  </li><li>May 8, 2019<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-ede-cy2019.pdf" data-entity-type="media" data-entity-uuid="2856aa58-c732-4d3b-962a-407065e77fd7" data-entity-substitution="canonical" type="application/pdf" title="FAQ: Enhanced Direct Enrollment Calendar Year 2019 Timeline (Updated)"><span class="mceNonEditable rx_inlinevariant">FAQ: Enhanced Direct Enrollment Calendar Year 2019 Timeline (Updated) (PDF)</span></a><span class="mceNonEditable rx_inlinevariant"> </span> </li><li>August 2, 2019<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-ede-cy2020.pdf" data-entity-type="media" data-entity-uuid="3f29e613-58d0-48a1-a472-55d00e69201d" data-entity-substitution="canonical" type="application/pdf" title="FAQ: Enhanced Direct Enrollment Calendar Year 2020 Timeline"><span class="mceNonEditable rx_inlinevariant">FAQ: Enhanced Direct Enrollment Calendar Year 2020 Timeline (PDF)</span></a><span class="mceNonEditable rx_inlinevariant"> </span> </li><li>November 5, 2019<br><a href="/cciio/programs-and-initiatives/health-insurance-marketplaces/downloads/qrs-faqs-for-de-entities.pdf" data-entity-type="media" data-entity-uuid="3557d5b2-3a2b-4dc1-9aaa-ddf4bf209729" data-entity-substitution="canonical" type="application/pdf" title="FAQ: Quality Rating Information Bulletin’s (Quality Bulletin’s) Display Guidelines for Direct Enrollment (DE) Entities"><span class="mceNonEditable rx_inlinevariant">FAQ: Quality Rating Information Bulletin’s (Quality Bulletin’s) Display Guidelines for Direct Enrollment (DE) Entities (PDF)</span></a></li><li>April 21, 2020<br><a href="/cciio/programs-and-initiatives/health-insurance-marketplaces/downloads/faqs-issuer-flex-um-pa.pdf" data-entity-type="media" data-entity-uuid="3dffaf64-b2cd-4995-8d2e-4df168882caf" data-entity-substitution="canonical" title="FAQs-Issuer-Flex-UM-PA ">FAQs on Issuer Flexibilities for Utilization Management and Prior Authorization (PDF)</a></li><li>December 17, 2020<br><a href="https://marketplace.cms.gov/technical-assistance-resources/medicare-periodic-data-matching-faq.pdf">FAQ: Medicare Periodic Data Matching</a></li><li>December 29, 2020<br><a href="https://marketplace.cms.gov/technical-assistance-resources/medicaid-chip-periodic-data-matching-faq.pdf">FAQ: Medicaid/CHIP Periodic Data Matching</a></li><li>August 9, 2022<br><a href="/files/document/2022-blueprint-application-exchanges.pdf" data-entity-type="media" data-entity-uuid="3c1b09ab-5aac-40ed-85d8-b373ce3a8d84" data-entity-substitution="canonical" title="2022 Blueprint Application for Exchanges">Blueprint for Approval of State-Based Health Insurance Exchanges (PDF)</a></li><li>January 27, 2023<br><a href="/technical-assistance-resources/temp-sep-unwinding-faq.pdf" data-entity-type="media" data-entity-uuid="7460a90b-fc35-4eab-ab8f-769533f05d1e" data-entity-substitution="canonical" title="temp-SEP-unwinding-FAQ">Temporary Special Enrollment Period (SEP) for Consumers Losing Medicaid or the Children’s Health Insurance Program (CHIP) Coverage Due to Unwinding of the Medicaid Continuous Enrollment Condition– Frequently Asked Questions (FAQ) (PDF)</a></li><li>May 16, 2023<br><a href="/files/document/faqs-marketplace-unwinding.pdf" data-entity-type="media" data-entity-uuid="04100b9c-4b80-412b-800a-bf34bb333475" data-entity-substitution="canonical" title="FAQs Marketplace Unwinding">Medicaid Continuous Enrollment Condition Unwinding Marketplace Frequently Asked Questions (FAQ) (PDF)</a></li><li>May 25, 2023<br><a href="/files/document/faqs-companion-resource.pdf" data-entity-type="media" data-entity-uuid="a525617b-efc5-46ee-ba38-d0838c0cf22d" data-entity-substitution="canonical" title="FAQS Companion Resource">Medicaid Continuous Enrollment Condition Unwinding Marketplace Frequently Asked Questions (FAQ) Companion Resource (PDF)</a></li><li><a href="/marketplace/technical-assistance-resources/medicaid-chip-periodic-data-matching-faq-2024.pdf" data-entity-type="media" data-entity-uuid="ddcd0a71-d0c6-4e01-8a03-437244840d40" data-entity-substitution="canonical" title="FAQs Medicaid and CHIP Periodic Data Matching_final ltr">FAQ: Medicaid/CHIP Periodic Data Matching: Updated Guidance (PDF)</a></li><li>August 14, 2024<br><a href="/cciio/programs-and-initiatives/health-insurance-marketplaces/downloads/faqs-sbe-reporting-enrollment-data-inaccuracies.pdf" data-entity-type="media" data-entity-uuid="8a572d20-4f52-45b7-a77d-5b0f0f68b6c6" data-entity-substitution="canonical" title="FAQs SBE Reporting and Reviewing Inaccuracies_508">Reporting and Reviewing Enrollment Payment Data Inaccuracy Reports in State-based Exchanges (SBE) Frequently Asked Questions and Answers (FAQs) (PDF)</a> (revised October 4, 2024)</li></ul><h3><a class="ck-anchor" id="In-Person Assistance"></a>In-Person Assistance</h3><p><strong>Fact Sheets</strong></p><ul><li>June 10, 2014<br><a href="/files/document/assistanceroles-06-10-14-508-2pdf">Helping Consumers Apply & Enroll Through the Marketplace (PDF - 213KB) (PDF)</a><br><a href="/cciio/resources/fact-sheets-and-faqs/navigator-foa" data-entity-type="node" data-entity-uuid="bbb88600-4925-45c5-b981-71115ee58772" data-entity-substitution="canonical" title="New Funding Opportunity Announcement for Navigators in Federally-facilitated and State Partnership Marketplaces">Navigator Funding Opportunity Announcement</a></li></ul><p><strong>FAQs</strong></p><ul><li>April 9, 2013<br><a href="https://wcms.cms.gov:9009/Rhythmyx/assembler/render?sys_revision=3&sys_context=0&sys_authtype=0&sys_variantid=1197&sys_contentid=161051">Frequently Asked Questions: Navigator Funding Opportunity Announcement</a><br><a href="/cciio/resources/files/downloads/navigator-foa-application-overview-4-9-2013.pdf" data-entity-type="media" data-entity-uuid="96679b82-9e98-468c-8d4f-9280840c2011" data-entity-substitution="canonical" title="navigator-foa-application-overview-4-9-2013">Overview of Applying for the Cooperative Agreement to Support Navigators in Federally-facilitated and State Partnership Marketplaces (PDF - 381 KB) (PDF)</a></li></ul><h3><a class="ck-anchor" id="Plan_Management"></a>Plan Management</h3><p><strong>Fact Sheets</strong></p><ul><li>February 20, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/ehb-2-20-2013" data-entity-type="node" data-entity-uuid="e8e70112-562a-4f96-af50-9b04e4a788f1" data-entity-substitution="canonical" title="Essential Health Benefits Standards: Ensuring Quality, Affordable Coverage ">Essential Health Benefits Standards: Ensuring Quality, Affordable Coverage</a></li><li>November 27, 2017<br><a href="/cciio/resources/fact-sheets-and-faqs/2019-draft-annual-letter-to-issuers-for-2019" data-entity-type="node" data-entity-uuid="839295ba-2ddb-4676-b6e2-f3b33e00e1c7" data-entity-substitution="canonical" title="FACT SHEET: 2019 Draft Annual Letter to Issuers for 2019">2019 Draft Annual Letter to Issuers for 2019</a></li></ul><p><strong>FAQs</strong></p><ul><li>February 17, 2012<br><a href="/cciio/resources/files/downloads/ehb-faq-508.pdf" data-entity-type="media" data-entity-uuid="04c2389d-bd54-4003-af12-b4ac213af6b9" data-entity-substitution="canonical" title="ehb-faq-508">Frequently Asked Questions on the Essential Health Benefits Bulletin (PDF – 88 KB) (PDF)</a></li><li>February 20, 2013<br><a href="/cciio/resources/files/downloads/plan-management-faq-2-20-2013.pdf" data-entity-type="media" data-entity-uuid="9065b1e2-e2d5-4666-bdc3-44faf41539eb" data-entity-substitution="canonical" title="plan-management-faq-2-20-2013">State Evaluation of Plan Management Activities of Health Plans and Issuers  (PDF - 35 KB) (PDF)</a></li><li>August 8, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/state_response_table_faq_08aug2016__.pdf" data-entity-type="media" data-entity-uuid="afcfa1bd-1f4f-41bc-ba20-447256ba85c2" data-entity-substitution="canonical" title="State_Response_Table_FAQ_08AUG2016__">Auto Re-enrollment for QHPs no longer available in the Marketplace (PDF)</a></li><li>October 14, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-on-offmarketplace-enrollment-periods-09282016.pdf" data-entity-type="media" data-entity-uuid="6d9335b2-8c17-44e3-8239-e0e6741d5e52" data-entity-substitution="canonical" title="FAQ on OffMarketplace Enrollment Periods 09282016">Frequently Asked Questions on Health Insurance Marketplace Standards (PDF)</a></li><li>December, 16, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/second-lowest-cost-silver-plan-technical-faqs12162016.pdf" data-entity-type="media" data-entity-uuid="278f354b-7849-4db8-8457-344a09894838" data-entity-substitution="canonical" title="Second Lowest Cost Silver Plan Technical FAQs12162016">Second Lowest Cost Silver Plan Technical FAQs (PDF)</a></li><li>December 23, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq_on_compliance_safe_harbor_extension_122316.pdf" data-entity-type="media" data-entity-uuid="aad599cb-4035-4949-88d6-039394889374" data-entity-substitution="canonical" title="FAQ_on_Compliance_Safe_Harbor_Extension_122316">FAQ on Compliance Safe Harbor for Issuers Affected by the Extension of the Enrollment Deadline to December 19, 2016 (PDF)</a></li><li>January 3, 2017<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/medicaid-mco-faq-final.pdf" data-entity-type="media" data-entity-uuid="5a4b4769-4a6d-49f3-af2d-a0735058e491" data-entity-substitution="canonical" title="Medicaid MCO FAQ Final">Frequently Asked Questions on Medicaid Managed Care Organizations (PDF)</a></li><li>January 19, 2017<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/machine-readable-faq-11917.pdf" data-entity-type="media" data-entity-uuid="5ea4b554-4549-4097-9f44-9f4ad4451607" data-entity-substitution="canonical" title="MACHINE READABLE FAQ 1.19.17">Machine-Readable FAQ for FF-SHOP QHPs (PDF)</a></li><li>April 13, 2017<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-on-compliance-standard-for-ffm-issuers_4-13-17.pdf" data-entity-type="media" data-entity-uuid="0489ff06-39b2-4628-8a2f-01068881e8e2" data-entity-substitution="canonical" title="FAQ on Compliance Standard for FFM Issuers_4 13 17">FAQ on Compliance Standard for Issuers in Federally-facilitated Marketplaces (PDF)</a></li><li>October 23, 2018<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-defrayal-state-benefits.pdf" data-entity-type="media" data-entity-uuid="eb647262-ab20-475a-8042-273479f72cc2" data-entity-substitution="canonical" title="FAQ on Defrayal of State Required Additional Benefits">FAQ on Defrayal of State Required Additional Benefits (PDF)</a></li><li>December 14, 2018<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/reminderqhpagreement.pdf" data-entity-type="media" data-entity-uuid="b6fe7b26-efd9-403e-ae4b-3808d0274add" data-entity-substitution="canonical" title="Reminders to Qualified Health Plan Issuers: CMS QHP Agreement Requirements for PII Breach and Security Incident Reporting"><span class="mceNonEditable rx_inlinevariant">Reminders to Qualified Health Plan Issuers: CMS QHP Agreement Requirements for PII Breach and Security Incident Reporting (PDF) </span></a> </li><li>March 12, 2020<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/ehb-benchmark-coverage-of-covid-19.pdf" data-entity-type="media" data-entity-uuid="e57c2c05-5c10-44f7-a8e1-78e236ac5803" data-entity-substitution="canonical" title="EHB-Benchmark-Coverage-of-COVID-19">FAQs on Essential Health Benefits Coverage and the Coronavirus (COVID-19) (PDF)</a></li><li>November 20, 2024<br><a href="/files/document/ehb-grant-external-faq508.pdf" data-entity-type="media" data-entity-uuid="dbec81e1-eeed-4dd8-833d-8078245bb97b" data-entity-substitution="canonical" title="EHB Grant External FAQ_508">Frequently Asked Questions for the 2024 Essential Health Benefits (EHB)-Benchmark Plan Modernization Grant for States with a Federally-facilitated Exchange (FFE) Grant Program (Funding Opportunity) (PDF)</a></li></ul><h3><a class="ck-anchor" id="Exchange_Planning_and_Establishment_Grants"></a>Exchange Planning and Establishment Grants</h3><p><strong>Fact Sheets</strong></p><ul><li>July 29, 2010<br><a href="http://www.healthcare.gov/news/factsheets/esthealthinsurexch.html" title="Health Insurance Exchanges: State Planning and Establishment Grants - Opens in a new window" target="T163789"><span class="mceNonEditable rx_inlinevariant">Health Insurance Exchanges: State Planning and Establishment Grants</span><span class="mceNonEditable rx_inlinevariant LinkDisclaimer"> - Opens in a new window</span></a></li><li>January 20, 2011<br><a href="http://www.healthcare.gov/news/factsheets/exchestannc.html" title="Health Insurance Exchange Establishment Grants Fact Sheet - Opens in a new window" target="T163790"><span class="mceNonEditable rx_inlinevariant">Health Insurance Exchange Establishment Grants Fact Sheet</span><span class="mceNonEditable rx_inlinevariant LinkDisclaimer"> - Opens in a new window</span></a></li><li>November 21, 2011<br><a href="/CCIIO/Resources/Files/Downloads/cap_exchange_funding_memo.pdf">State Consumer Assistance Program Participation in Exchange Core Area 10 (PDF)</a></li><li>January 22, 2014<br><a href="/marketplace/states/creating-competitive-marketplace" data-entity-type="node" data-entity-uuid="9567fc18-3944-4876-9951-4655a12e2d24" data-entity-substitution="canonical" title="Creating a New Competitive Health Insurance Marketplace">Creating a New Competitive Marketplace: Health Insurance Exchange Establishment Grants Awards List</a></li></ul><p><strong>FAQs</strong></p><ul><li>June 29, 2012<br><a href="/cciio/resources/fact-sheets-and-faqs/hie-est-grant-faq-06292012" data-entity-type="node" data-entity-uuid="8230d731-b9a1-454d-9494-2813aae64ac3" data-entity-substitution="canonical" title="Exchange Establishment Cooperative Agreement Funding FAQs">Exchange Establishment Cooperative Agreement Funding FAQs</a></li><li>November 9, 2012<br><a href="/cciio/resources/fact-sheets-and-faqs/exchange-establishment-faq" data-entity-type="node" data-entity-uuid="1b3f598e-898b-4abd-8bf9-a8e1020eaf1d" data-entity-substitution="canonical" title="Exchange Establishment Cooperative Agreement Funding FAQs">Consolidated Exchange Establishment Cooperative Agreement Funding FAQs</a><br>This page contains information from the funding opportunity announcement and frequently asked questions from applicants.</li><li>April 23, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/marketplace-funding-marketing-faq" data-entity-type="node" data-entity-uuid="457f11e1-d2a0-42ef-92cb-34bf432b53a0" data-entity-substitution="canonical" title="Using Section 1311(a) Funding for Marketing Activities in a Plan Management State Partnership Marketplace or Federally-facilitated Marketplace FAQs">Using Section 1311(a) Funding for Marketing Activities in a Plan Management State Partnership Marketplace or Federally-facilitated Marketplace</a></li><li>May 13, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/ca-spm-funding" data-entity-type="node" data-entity-uuid="21db7dc8-5f08-4f06-b772-ac5d88baf418" data-entity-substitution="canonical" title="Frequently Asked Questions on Allowable Uses of Section 1311 Funding for States in a State Consumer Partnership Marketplace">Allowable Uses of Section 1311 Funding for States in a State Consumer Partnership Marketplace</a></li><li>May 13, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/spm-ffm-funding" data-entity-type="node" data-entity-uuid="21472124-7346-4980-9fd2-5be71adde7d4" data-entity-substitution="canonical" title="Frequently Asked Questions on Allowable Uses of Section 1311 Funding for States in a State Partnership Marketplace or in States with a Federally-Facilitated Marketplace">Allowable Uses of Section 1311 Funding for States in a State Partnership Marketplace or in States with a Federally-Facilitated Marketplace</a></li><li>December 5, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/change-orders-congressional-inquiries-funding-faq" data-entity-type="node" data-entity-uuid="103da176-b7ed-49b6-be0d-e4270d0ef88e" data-entity-substitution="canonical" title="Frequently Asked Questions on the use of 1311 funding for Change Orders and Congressional Inquiries ">Frequently Asked Questions on Use of 1311 funding for Change Orders and Congressional Inquiries</a></li><li>December 30, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/state-based-marketplace-annual-reporting-tool-faq-12-30-13.pdf" data-entity-type="media" data-entity-uuid="f6143e4d-b0a6-4754-b96c-d5740a59d5ee" data-entity-substitution="canonical" title="State-based Marketplaces (SBMs): Frequently Asked Questions on the State-based Marketplace Annual Reporting Tool (SMART)">State-based Marketplaces (SBMs): Frequently Asked Questions on the State-based Marketplace Annual Reporting Tool (SMART) (PDF)</a></li><li>February 27, 2014<br><a href="/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/retroactive-advance-payments-ptc-csrs-02-27-14.docx">CMS Bulletin to Marketplaces on Availability of Retroactive Advance Payments of the PTC and CSRs in 2014 Due to Exceptional Circumstances (DOCX)</a></li><li>March 14, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/no-cost-extension-faqs-3-14-14.pdf" data-entity-type="media" data-entity-uuid="c60629b9-3dc4-433e-8f49-20f6080e7a8a" data-entity-substitution="canonical" title="Use of 1311 Funds and No Cost Extensions">Use of 1311 Funds and No Cost Extensions (PDF)</a></li><li>September 19, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-1311-project-faqs-periods-508-compliant.pdf" data-entity-type="media" data-entity-uuid="350777ba-22cf-470a-a6b2-7c605ffe7b0b" data-entity-substitution="canonical" title="The Use of 1311 Funds, Project Periods, and Updating the Cost Allocation Methodology">(PDF) (PDF)</a><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq_1311_project_faqs_periods.pdf" data-entity-type="media" data-entity-uuid="5488b5e2-94ae-462a-8eee-96b23cd367c8" data-entity-substitution="canonical" title="The Use of 1311 Funds, Project Periods, and Updating the Cost Allocation Methodology">The Use of 1311 Funds, Project Periods, and Updating the Cost Allocation Methodology (PDF)</a></li><li>June 8, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-1311-project-faqs-periods-508-compliant.pdf" data-entity-type="media" data-entity-uuid="350777ba-22cf-470a-a6b2-7c605ffe7b0b" data-entity-substitution="canonical" title="The Use of 1311 Funds, Project Periods, and Updating the Cost Allocation Methodology">(PDF) (PDF)</a><a href="/cciio/resources/fact-sheets-and-faqs/downloads/final-1311-faq-06-08-15.pdf" data-entity-type="media" data-entity-uuid="e0e2f363-1c14-490e-bd18-8d60618aa8cc" data-entity-substitution="canonical" title="Clarification of the Use of 1311 Funds for Establishment Activities">Clarification of the Use of 1311 Funds for Establishment Activities (PDF)</a></li></ul><h3><a class="ck-anchor" id="Early_Innovator_Grants"></a>Early Innovator Grants</h3><p><strong>Fact Sheets</strong></p><ul><li>February 16, 2011<br><a href="/cciio/resources/grants/states-leading-the-way" data-entity-type="node" data-entity-uuid="ac76b7b1-e282-47ab-9e43-55b58a75980c" data-entity-substitution="canonical" title="States Leading the Way on Implementation: HHS Awards “Early Innovator” Grants to Seven States">States Leading the Way on Implementation: HHS Awards “Early Innovator” Grants to Seven States</a></li></ul><h3><a class="ck-anchor" id="Territory_Cooperative_Agreements"></a>Territory Cooperative Agreements</h3><p><strong>FAQs</strong></p><ul><li>February 15, 2011<br><a href="/cciio/resources/forms-reports-and-other-resources/territories_external_faq_2_15_2011" data-entity-type="node" data-entity-uuid="b8d4dc12-8ff4-4c93-86f3-99e5c90a1cdd" data-entity-substitution="canonical" title="Territory Cooperative Agreements for the Affordable Care Act’s Exchanges">Territory Cooperative Agreements for the Affordable Care Act’s Exchanges</a></li></ul><h2><a class="ck-anchor" id="Premium_Stabilization_Programs"></a>Premium Stabilization Programs</h2><p><strong>Fact Sheets</strong></p><ul><li>November 30, 2012<br><a href="/cciio/resources/files/downloads/proposed-payment-notice-technical-summary-11-30-20.pdf" data-entity-type="media" data-entity-uuid="3425d94b-f008-490b-a2c6-6d49b6a66652" data-entity-substitution="canonical" title="proposed-payment-notice-technical-summary-11-30-20">Technical Fact Sheet: Draft Notice of Payment and Benefit Parameters (PDF – 117 KB) (PDF)</a></li><li>March 1, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/paymentnotice-3-1-2013" data-entity-type="node" data-entity-uuid="7d8463e5-ce11-4414-9f2b-72de3408148c" data-entity-substitution="canonical" title="HHS Notice of Benefit and Payment Parameters">HHS Notice of Benefit and Payment Parameters</a></li><li>March 11, 2013<br><a href="/cciio/resources/files/downloads/payment-notice-technical-summary-3-11-2013.pdf" data-entity-type="media" data-entity-uuid="a3238400-1600-4793-b25a-517d24102557" data-entity-substitution="canonical" title="payment-notice-technical-summary-3-11-2013">Technical Fact Sheet: HHS Notice of Benefit and Payment Parameters for 2014 (PDF - 234 KB) (PDF)</a></li><li>November 25, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/proposed-2015-payment-notice" data-entity-type="node" data-entity-uuid="cb120f09-cf44-4c9c-9e5a-df990e9b06cd" data-entity-substitution="canonical" title="Proposed HHS Notice of Benefit and Payment Parameters for 2015">Proposed 2015 HHS Notice of Benefit and Payment Parameters</a></li><li>November 21, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/fact-sheet-11-20-14.pdf" data-entity-type="media" data-entity-uuid="ce912633-3174-487e-9448-9cc25c48bfe6" data-entity-substitution="canonical" title="Proposed 2016 HHS Notice of Benefit and Payment Parameters Fact Sheet">Proposed 2016 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</a></li><li>February 20, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/2016-pn-fact-sheet-final.pdf" data-entity-type="media" data-entity-uuid="28369626-98b7-4512-87cd-a75951a82a20" data-entity-substitution="canonical" title="2016 PN Fact Sheet final">Final 2016 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</a></li><li>November 20, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/cms-9937-p-fact-sheet-final-112015.pdf" data-entity-type="media" data-entity-uuid="a03d6e2e-e4d4-4bac-a6c3-3c2b2597a5bf" data-entity-substitution="canonical" title="CMS-9937-P Fact Sheet - final 11.20.15">Proposed 2017 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</a></li><li>February 29, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/cms-9937-f_fact_sheet_final_2-29-16.pdf" data-entity-type="media" data-entity-uuid="b10edda2-ee2e-4c21-a2b9-4c6021fd31bb" data-entity-substitution="canonical" title="CMS-9937-F Fact Sheet Final 2 29 16">Final 2017 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</a></li><li>August 29, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/cms-9934-p-fact-sheet-8-29-16.pdf" data-entity-type="media" data-entity-uuid="a620ba9f-207a-4e59-ba4c-1e30486db9ea" data-entity-substitution="canonical" title="CMS-9934-P Fact Sheet 8 29 16">Proposed 2018 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</a></li><li>December 16, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/cms-9934-f-fact-sheet-12-16-16.pdf" data-entity-type="media" data-entity-uuid="39868206-a647-4c3e-9b5c-b4d53727be40" data-entity-substitution="canonical" title="CMS-9934-F Fact Sheet 12 16 16">Final 2018 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</a></li><li>October 27, 2017<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/proposed-2019-hhs-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="06fe5295-ce7c-43f6-a4c0-dfabbf62ff47" data-entity-substitution="canonical" title="Proposed 2019 HHS Notice of Benefit and Payment Parameters Fact Sheet">Proposed 2019 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</a></li><li>January 17, 2019<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/proposed-2020-hhs-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="fa74dfdf-e147-4153-ae24-69e95a06bf20" data-entity-substitution="canonical" title="Proposed 2020 HHS Notice of Benefit and Payment Parameters Fact Sheet">Proposed 2020 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</a></li><li>April 18, 2019<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/cms-9926-f-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="e90e236d-a839-48b4-9b19-a9fcdda25b54" data-entity-substitution="canonical" type="application/pdf" title="Final 2020 HHS Notice of Benefit and Payment Parameters Fact Sheet"><span class="mceNonEditable rx_inlinevariant">Final 2020 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</span></a></li><li>January 31, 2020<br><a href="/files/document/proposed-2021-hhs-notice-benefit-and-payment-parameters-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="793b9f3f-614c-4fb4-bf3b-66d44b256e00" data-entity-substitution="canonical" title="Proposed 2021 HHS Notice of Benefit and Payment Parameters Fact Sheet">Proposed 2021 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</a></li><li>May 7, 2020<br><a href="/files/document/final-2021-hhs-notice-benefit-and-payment-parameters-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="d84f8f2c-89b7-4a4e-be41-fe5489933280" data-entity-substitution="canonical" title="Final 2021 hhs notice benefit and payment parameters fact sheet">Final 2021 <span>HHS Notice of Benefit and Payment Parameters Fact Sheet</span> (PDF)</a></li><li>August 25, 2020<br><a href="/files/document/cciio-premium-reductions-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="bef3d9ca-25d2-4803-a2a7-2b47655dce5a" data-entity-substitution="canonical" title="CCIIO-Premium-Reductions-Fact-Sheet">Technical Fact Sheet: CCIIO Premium Reductions:  Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (PDF)</a></li><li>August 25, 2020<br><a href="/files/document/covid-ifc-3-8-25-20.pdf" data-entity-type="media" data-entity-uuid="5d147c4f-7e08-4d3b-aa10-d7b69cb37061" data-entity-substitution="canonical" title="COVID IFC 3 8 25 20">Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (PDF)</a></li><li>November 25, 2020<br><a href="/files/document/proposed-2022-hhs-notice-benefit-and-payment-parameters-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="3b0ca18a-d58d-46b2-ac5d-b5f5b3588c95" data-entity-substitution="canonical" title="2022-hhs-notice-benefit-and-payment-parameters-fact-sheet">Proposed 2022 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</a></li><li>January 14, 2021<br><a href="/files/document/final-2022-hhs-notice-benefit-and-payment-parameters-fact-sheet.pdf" data-entity-type="media" data-entity-uuid="62eb1333-b7c5-4388-9907-7f23c62dd8e8" data-entity-substitution="canonical" title="final-2022-hhs-notice-benefit-and-payment-parameters-fact-sheet">Final 2022 HHS Notice of Benefit and Payment Parameters Fact Sheet (PDF)</a></li></ul><p><strong>FAQs</strong></p><ul><li>September 12, 2011<br><a href="/cciio/resources/forms-reports-and-other-resources/risk_adjustment_implementation_issues" data-entity-type="node" data-entity-uuid="898e7071-354b-4371-be91-256f64abfab8" data-entity-substitution="canonical" title="Risk Adjustment Implementation Issues">Questions and Answers on Risk Adjustment White Paper</a></li><li>November 8, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/reinsurance-faq-11-08-2013.pdf" data-entity-type="media" data-entity-uuid="6839e010-6a2d-4f05-9121-bd48a481054f" data-entity-substitution="canonical" title="Question and Answer on Submission of Reinsurance Enrollment Count">Question and Answer on Submission of Reinsurance Enrollment Count (PDF)</a> (PDF – 127 KB)</li><li>April 11, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-risk-corridors-04-11-2014.pdf" data-entity-type="media" data-entity-uuid="236c9675-d78c-4708-9dc7-4fcc858af05f" data-entity-substitution="canonical" title="Question and Answer on Budget Neutrality for the Risk Corridors">Question and Answer on Budget Neutrality for the Risk Corridors (PDF)</a></li><li>May 22, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/reinsurance-contributions-process-faq-5-22-14.pdf" data-entity-type="media" data-entity-uuid="5a445cc6-6edc-40c7-9630-f0227e785c8d" data-entity-substitution="canonical" title="Questions and Answers on Reinsurance Contributions Process">Questions and Answers on Reinsurance Contributions Process (PDF)</a></li><li>June 8, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/ra-onsiteqa-060816.pdf" data-entity-type="media" data-entity-uuid="477d638c-8370-41ec-a426-293b35dccd7b" data-entity-substitution="canonical" title="RA_OnsiteQA_060816">Questions and Answers from the March 31, 2016, HHS-Operated Risk Adjustment Methodology Meeting (PDF)</a></li><li>July 26, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/rc-mlr-faq-072616.pdf" data-entity-type="media" data-entity-uuid="c21482b5-3f84-4d76-a81b-2cc5d9398e40" data-entity-substitution="canonical" title="RC-MLR-FAQ-072616">Deadline for Submission of MLR and Risk Corridors Data for the 2015 Benefit Year (PDF)</a></li><li>August 22, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/ffm-uf_adjustment_faq_2015.pdf" data-entity-type="media" data-entity-uuid="d995531a-db9b-40f1-8ddb-53514990a86f" data-entity-substitution="canonical" title="FFM UF_adjustment_FAQ_2015">FAQs for Federally-facilitated Marketplace (FFM) User Fee Adjustment Submission Requirements (PDF)</a></li><li>October 27, 2017<br><a href="/cciio/resources/forms-reports-and-other-resources/downloads/faqs-ffe-requirements-2016.pdf" data-entity-type="media" data-entity-uuid="15ee2af0-41f4-4158-97b2-12a0ce7d59d7" data-entity-substitution="canonical" title="FAQs for Federally-facilitated Exchange (FFE) User Fee Adjustment Submission Requirements Benefit Year 2016">FAQs for Federally-facilitated Exchange (FFE) User Fee Adjustment Submission Requirements Benefit Year 2016 (PDF)</a></li><li>May 7, 2018<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-ffe-adjustment-submission-requirements.pdf" data-entity-type="media" data-entity-uuid="e6484e89-ffd2-4f10-881e-b8cdf2948f88" data-entity-substitution="canonical" type="application/pdf" title="FAQs for Federally-facilitated Exchange (FFE) User Fee Adjustment Submission Requirements Benefit"><span class="mceNonEditable rx_inlinevariant">FAQs for Federally-facilitated Exchange (FFE) User Fee Adjustment Submission Requirements Benefit (PDF)</span></a><span class="mceNonEditable rx_inlinevariant"> </span> </li><li>April 8, 2019<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-for-2018-benefit-year-cost-sharing-reduction-csr-data-submission.pdf" data-entity-type="media" data-entity-uuid="b2de8876-75a2-454f-a568-d055098132fa" data-entity-substitution="canonical" type="application/pdf" title="FAQs for 2018 Benefit Year Cost-sharing Reduction (CSR) Data Submission"><span class="mceNonEditable rx_inlinevariant">FAQs for 2018 Benefit Year Cost-sharing Reduction (CSR) Data Submission (PDF)</span></a></li><li>May 8, 2019<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-ffe-user-fee-adjustment-submission.pdf" data-entity-type="media" data-entity-uuid="9fbe9647-5712-43d4-90d4-06f3efe6a175" data-entity-substitution="canonical" title="FAQs for Federally-facilitated Exchange (FFE) User Fee Adjustment Submission">FAQs for Federally-facilitated Exchange (FFE) User Fee Adjustment Submission (PDF)</a><br>This set of FAQs addresses the federally-facilitated exchange (FFE) User Fee Adjustment submission process and is intended to assist issuers and TPAs (including PBMs) with navigating the submission requirements and understanding the mechanism through which CMS will apply the FFE user fee adjustment to FFE issuers.</li><li>April 24, 2020<br><a href="/cciio/resources/regulations-and-guidance/downloads/document-7-csr-faqs-for-by-2019-040120-5cr-040120.pdf" data-entity-type="media" data-entity-uuid="cbdbf5a8-b89c-44a7-bdaf-439dba990f27" data-entity-substitution="canonical" title="Document-7-CSR-FAQs-for-BY-2019-040120-5CR-040120">FAQs <span lang="EN">for 2019 Benefit Year Cost-sharing Reduction (CSR) Data Submission</span> (PDF)</a></li><li>April 13, 2021<br><a href="/cciio/resources/regulations-and-guidance/downloads/csr-faqs-for-by-2020-041321.pdf" data-entity-type="media" data-entity-uuid="80b5eecb-3010-4388-9833-43b81815bde2" data-entity-substitution="canonical" title="FAQs for 2020 CSR Data Submission 4.13.21_508">FAQs <span lang="EN">for 2020 Benefit Year Cost-sharing Reduction (CSR) Data Submission</span> (PDF)</a></li><li>May 13, 2024<br><a href="/files/document/telehealth-faq-2024-update-51324-clean.pdf" data-entity-type="media" data-entity-uuid="758bbc70-ca12-42e9-94b9-83a630608b76" data-entity-substitution="canonical" title="Telehealth FAQ 2024 update 5.13.24 clean">Risk Adjustment Telehealth and Audio-only Services FAQ (PDF)</a><br>This guidance document replaces previous Risk Adjustment Telehealth and Telephone Services During COVID-19 FAQs listed above.</li></ul><h2><a class="ck-anchor" id="Consumer Operated and Oriented Plan (CO-OP) Program"></a>Consumer Operated and Oriented Plan (CO-OP) Program</h2><p><strong>FAQs</strong></p><ul><li>October 11, 2011<br><a href="/cciio/resources/funding-opportunities/coop_foa_faq" data-entity-type="node" data-entity-uuid="519ee7b4-4811-4f61-a994-4cf543af4068" data-entity-substitution="canonical" title="Consumer Operated and Oriented Plan (CO-OP) Program">Frequently Asked Questions regarding the CO-OP Program FOA</a></li><li>January 27, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/co-op-questions-final-1-27-16.pdf" data-entity-type="media" data-entity-uuid="b676706f-1b4c-4570-94c4-7f95c44ca5ec" data-entity-substitution="canonical" title="CO-OP Questions Final 1 27 16">Frequently Asked Questions regarding the CO-OP Program (PDF)</a></li></ul><p><strong>Fact Sheets</strong></p><ul><li>December 8, 2011<br><a href="/cciio/resources/fact-sheets-and-faqs/coop_final_rule" data-entity-type="node" data-entity-uuid="6e6f73e3-e795-4785-9c50-27e22dd0e4bf" data-entity-substitution="canonical" title="New Federal Loan Program Helps Nonprofits Create Customer-Driven Health Insurers">New Federal Loan Program Helps Nonprofits Create Customer-Driven Health Insurers</a></li><li>September 26, 2014<br><a href="/cciio/resources/grants/new-loan-program" data-entity-type="node" data-entity-uuid="0795c566-c219-412b-bec1-fffbe62b1204" data-entity-substitution="canonical" title="Loan Program Helps Support Customer-Driven Non-Profit Health Insurers">CO-OP Awardees Announced</a></li></ul><h2><a class="ck-anchor" id="Other_Insurance_Protections"></a>Other Insurance Protections</h2><h3><a class="ck-anchor" id="COBRA"></a>COBRA</h3><p><strong>Fact Sheets</strong></p><ul><li>October 17, 2012<br><a href="/cciio/programs-and-initiatives/other-insurance-protections/cobra_fact_sheet" data-entity-type="node" data-entity-uuid="6b98c8f5-1b09-4697-b815-21241cd38a64" data-entity-substitution="canonical" title="COBRA Continuation Coverage">COBRA Continuation Coverage</a></li></ul><p><strong>FAQs</strong></p><ul><li>October 19, 2011<br><a href="/cciio/programs-and-initiatives/other-insurance-protections/cobra_qna" data-entity-type="node" data-entity-uuid="63c7deef-dff6-439d-b711-f3fbf8ac1bde" data-entity-substitution="canonical" title="COBRA Continuation Coverage Questions and Answers">COBRA Continuation Coverage Questions and Answers</a></li></ul><h3><a class="ck-anchor" id="Mental_Health_Parity"></a>Mental Health Parity</h3><p><strong>Fact Sheets</strong></p><ul><li>October 25, 2011<br><a href="/marketplace/private-health-insurance/mental-health-parity-addiction-equity" data-entity-type="node" data-entity-uuid="3542ef99-e2a9-4c5d-b0ba-5a90d5017ca6" data-entity-substitution="canonical" title="The Mental Health Parity and Addiction Equity Act (MHPAEA)">Mental Health Parity and Addiction Equity Act</a> </li><li>October 27, 2016<br><a href="http://www.hhs.gov/parity">Final Report of President Obama’s Mental Health and Substance Use Disorder Parity Task Force</a></li><li>October 27, 2016<br><a href="http://www.hhs.gov/parity">Factsheet: Mental Health and Substance Use Disorder Parity Task Force Announces New Actions and Recommendations</a></li><li>October 27, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/compliance_assistance_materials_index_10-25-16_4-40pm.pdf" data-entity-type="media" data-entity-uuid="64e5066c-faa6-48a8-b4a0-24dff219cfd4" data-entity-substitution="canonical" title="Compliance_Assistance_ Materials_Index_10-25-16_4 40pm">Compliance Assistance Materials Index (PDF)</a></li><li>September 9, 2024<br><a href="/files/document/mhpaea-final-rule-omnibus-clean-9424-final-posting508.pdf" data-entity-type="media" data-entity-uuid="3d4a7271-a7bd-4ab1-8812-c0f62fcbcfb0" data-entity-substitution="canonical" title="MHPAEA final rule omnibus clean 9.4.24 Final for Posting_508">Final Rules under the Mental Health Parity and Addiction Equity Act (MHPAEA) Fact Sheet (PDF)</a></li></ul><p><strong>FAQs</strong></p><ul><li>December 22, 2010<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs5" data-entity-type="node" data-entity-uuid="a42ee5a3-c242-48cf-98b1-75e0af39ec9b" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 5">Mental Health Parity Implementation (ACA FAQs Set 5)</a></li><li>November 17, 2011<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs7" data-entity-type="node" data-entity-uuid="be7c97bd-8637-42fc-982d-3560081fd657" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 7">Mental Health Parity Implementation (ACA FAQs Set 7)</a></li><li>November 8, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs17" data-entity-type="node" data-entity-uuid="2514eeb2-482f-412a-8c39-108ca874246f" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 17">Mental Health Parity Implementation (ACA FAQs Set 17)</a></li><li>January 9, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/aca_implementation_faqs18" data-entity-type="node" data-entity-uuid="7bceba8c-3c23-4e3b-be8b-62a9836c79cf" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs - Set 18">Mental Health Parity Implementation (ACA FAQs Set 18)</a></li><li>October 23, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-xxix.pdf" data-entity-type="media" data-entity-uuid="d3960539-56b6-4f53-876f-37fc6c9f88c8" data-entity-substitution="canonical" title="Affordable Care Act Implementation (Set 29)">Mental Health Parity Implementation (ACA FAQs Set 29) (PDF)</a></li><li>April 20, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-31_final-4-20-16.pdf" data-entity-type="media" data-entity-uuid="72a6268b-7c05-4ba9-b1f2-7201f758502b" data-entity-substitution="canonical" title="FAQs 31_Final 4-20-16">Mental Health Parity Implementation (ACA FAQs Set 31) (PDF)</a></li><li>October 27, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-part-34_10-26-16_final.pdf" data-entity-type="media" data-entity-uuid="5590ff18-41f7-4a81-a66a-70271bd4ba9c" data-entity-substitution="canonical" title="FAQ part 34_10-26-16_FINAL">Mental Health Parity Implementation (ACA FAQs Set 34) (PDF)</a></li><li>June 16, 2017<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-part-38.pdf" data-entity-type="media" data-entity-uuid="7c40b06c-992d-4792-8d2c-4cbd8e7b6038" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs (Set 38)">Mental Health Parity Implementation (ACA FAQs Set 38) (PDF)</a><br>Related information: <a href="/cciio/resources/forms-reports-and-other-resources/downloads/model-form-to-request-mh-sud-treatment-limitation-information.pdf" data-entity-type="media" data-entity-uuid="02193ebe-0c30-4fde-90d1-284f316b9085" data-entity-substitution="canonical" title="Draft Model Form to Request Documentation from an Employer-Sponsored Health Plan or an Insurer Concerning Treatment Limitations">Draft MHPAEA Disclosure Template (PDF)</a></li><li>April 23, 2018<br><a href="https://www.dol.gov/sites/dolgov/files/ebsa/about-ebsa/our-activities/resource-center/faqs/aca-part-39-proposed.pdf">Mental Health Parity Implementation (ACA FAQs Set 39 - Proposed)</a></li><li>September 5, 2019<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faqs-part-39.pdf" data-entity-type="media" data-entity-uuid="9a5b7f27-fc16-4459-b775-7a76e0409b51" data-entity-substitution="canonical" title="Affordable Care Act Implementation FAQs (Set 39)">Mental Health Parity Implementation (ACA FAQs Set 39 - Final) (PDF)</a><br>Related information: <span class="mceNonEditable rx_inlinevariant"> </span><a href="/cciio/resources/fact-sheets-and-faqs/downloads/mhpaea-disclosure-template.docx" data-entity-type="media" data-entity-uuid="85aaf7de-669b-432e-a183-9b3b55a4964b" data-entity-substitution="canonical" type="application/vnd.openxmlformats-officedocument.wordprocessingml.document" title="MHPAEA Disclosure Template"><span class="mceNonEditable rx_inlinevariant">MHPAEA Disclosure Template (DOCX)</span></a><span class="mceNonEditable rx_inlinevariant"> </span>  <a href="/cciio/resources/fact-sheets-and-faqs/downloads/mhpaea-disclosure-template-1.pdf" data-entity-type="media" data-entity-uuid="b2427b54-19de-4464-9cfd-1bb8be005963" data-entity-substitution="canonical" type="application/pdf" title="MHPAEA-Disclosure-Template.pdf"><span class="mceNonEditable rx_inlinevariant">(PDF)</span> (PDF)</a><span class="mceNonEditable rx_inlinevariant"> </span> </li><li><span>April 2, 2021</span><br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/mhpaea-faqs-part-45.pdf" data-entity-type="media" data-entity-uuid="345045c8-9031-469f-9f01-9e884ae41089" data-entity-substitution="canonical" title="FAQs-Part-45"><span>Mental Health Parity Implementation (ACA FAQs Set 45) (PDF)</span></a></li></ul><h3><a class="ck-anchor" id="Newborns_and_Mothers_Health_Protection"></a>Newborns' and Mothers Health Protection</h3><p><strong>Fact Sheets</strong></p><ul><li>January 30, 2012<br><a href="/cciio/programs-and-initiatives/other-insurance-protections/nmhpa_factsheet" data-entity-type="node" data-entity-uuid="8c916bd5-e1c9-419a-9ac8-c43376e1fbcf" data-entity-substitution="canonical" title="Newborns' and Mothers' Health Protection Act (NMHPA)">Newborns' and Mothers' Health Protection Act of 1996 (NMHPA)</a></li></ul><h3><a class="ck-anchor" id="Womens_Health_and_Cancer_Rights"></a>Women's Health and Cancer Rights</h3><p><strong>Fact Sheets</strong></p><ul><li>January 30, 2012<br><a href="/cciio/programs-and-initiatives/other-insurance-protections/whcra_factsheet" data-entity-type="node" data-entity-uuid="8157bef8-5694-465f-8a72-22eab5fb8e24" data-entity-substitution="canonical" title="Women's Health and Cancer Rights Act (WHCRA)">Women's Health and Cancer Rights Act of 1998 (WHCRA)</a> </li></ul><h2><a class="ck-anchor" id="Health_Market_Reforms"></a>Health Insurance Market Reforms</h2><p><strong>Fact Sheets</strong></p><ul><li>November 20, 2012<br><a href="/cciio/resources/files/downloads/market-rules-nprm-technical-summary-11-20-2012.pdf" data-entity-type="media" data-entity-uuid="12f23ab6-3ff6-4424-bf12-aec259ca5da0" data-entity-substitution="canonical" title="Technical Fact Sheet: Proposed Rule for Health Insurance Market Reforms">Technical Fact Sheet: Proposed Rule for Health Insurance Market Reforms (PDF - 128 KB) (PDF)</a></li><li>February 22, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/marketreforms-2-22-2013" data-entity-type="node" data-entity-uuid="03cfdc24-d32f-4090-9bdd-d2086510c119" data-entity-substitution="canonical" title="Overview: Final Rule for Health Insurance Market Reforms">Final Rule for Health Insurance Market Reforms</a></li><li>February 27, 2013<br><a href="/cciio/resources/files/downloads/market-rules-technical-summary-2-27-2013.pdf" data-entity-type="media" data-entity-uuid="b4c3e47e-7b87-4415-b8a0-4e83e645910f" data-entity-substitution="canonical" title="market-rules-technical-summary-2-27-2013">Technical Fact Sheet: Health Insurance Market Reforms  (PDF - 75 KB) (PDF)</a></li><li>March 15, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/compliance-3-15-2013" data-entity-type="node" data-entity-uuid="5a28e373-5147-438c-9841-ade148e02859" data-entity-substitution="canonical" title="Ensuring Health Insurance Protections for Consumers">Ensuring Health Insurance Protections for Consumers</a></li><li>March 14, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/marketstandards-3-14-2014" data-entity-type="node" data-entity-uuid="05fea790-8373-4ee4-97ee-02b70e7cc92c" data-entity-substitution="canonical" title="Exchange and Insurance Market Standards for 2015 and Beyond and Final 2015 Letter to Issuers in the Federally-facilitated Marketplace">Exchange and Insurance Market Standards for 2015 and Beyond and Final 2015 Letter to Issuers in the Federally-facilitated Marketplace</a></li><li>May 16, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/marketstandards-5-16-2014" data-entity-type="node" data-entity-uuid="875dfe70-33a8-4e3d-b259-30f15e4cc561" data-entity-substitution="canonical" title="Exchange and Insurance Market Standards for 2015 and Beyond">Exchange and Insurance Market Standards for 2015 and Beyond</a></li></ul><p><strong>FAQs</strong></p><ul><li>April 26, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/qa_hmr" data-entity-type="node" data-entity-uuid="6d002dce-9b83-4d35-bdd6-a079443306f5" data-entity-substitution="canonical" title="Questions and Answers Related to the Health Insurance Market Reforms ">Questions and Answers Related to the Health Insurance Market Reforms</a></li><li>May 16, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/final-master-faqs-5-16-14.pdf" data-entity-type="media" data-entity-uuid="fd5a8eb5-b720-4005-a443-b868f9fcf5e1" data-entity-substitution="canonical" title="Frequently Asked Questions on Health Insurance Market Reforms and Marketplace Standards">Frequently Asked Questions on Health Insurance Market Reforms and Marketplace Standards (PDF)</a></li><li>June 3, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq_on_qhps_and_guaranteed_availability_6314.pdf" data-entity-type="media" data-entity-uuid="f5a5c617-afd6-4eb2-af7b-353acfce7c25" data-entity-substitution="canonical" title="Frequently Asked Question on Qualified Health Plans and Guaranteed Availability Standards">Frequently Asked Question on Qualified Health Plans and Guaranteed Availability Standards (PDF)</a></li><li>April 16, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/hhs-wellness-faqs-4-16-15-pdf-adobeacrobatpro.pdf" data-entity-type="media" data-entity-uuid="8ce2c1b5-24f4-4b50-b259-fab64b01b95c" data-entity-substitution="canonical" title="Frequently Asked Questions on Health Insurance Market Reforms and Wellness Programs">Frequently Asked Questions on Health Insurance Market Reforms and Wellness Programs (PDF)</a></li><li>June 15, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/uniform-mod-and-plan-wd-faq-06-15-2015.pdf" data-entity-type="media" data-entity-uuid="71bf6670-84cb-4fd4-b168-dafc3b477d80" data-entity-substitution="canonical" title="Frequently Asked Questions on Uniform Modification and Plan/Product Withdrawal">Frequently Asked Questions on Uniform Modification and Plan/Product Withdrawal (PDF)</a></li><li>October 19, 2015<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq-on-the-impact-of-the-pace-act-on-state-small-group-expansion-12-17-15.pdf" data-entity-type="media" data-entity-uuid="2588efb1-c69f-433c-b18f-4921e2243322" data-entity-substitution="canonical" title="FAQ on the Impact of the PACE Act on State Small Group Expansion 12.17.15">Frequently Asked Questions on the Impact of PACE Act on State Small Group Expansion (PDF)</a><br>*Updated December 17, 2015</li><li>February 29, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/final_9010_faq_2-29-16.pdf" data-entity-type="media" data-entity-uuid="09608bf5-5989-4cdd-9ee6-2661e2630d09" data-entity-substitution="canonical" title="FINAL 9010 FAQ 2 29 16">Frequently Asked Questions on the 2017 Moratorium on Health Insurance Provider Fee (PDF)</a></li><li>May 26, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/waiting-period-faq-05262016-final-.pdf" data-entity-type="media" data-entity-uuid="688c6c76-35bb-41a2-9d30-9f716082ef1a" data-entity-substitution="canonical" title="Waiting period FAQ 05262016 Final">Frequently Asked Question on Health Insurance Market Reforms and Marketplace Standards (PDF)</a></li><li>December 16, 2016<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/agent-broker-compensation-and-discriminatory-marketing-practices.pdf" data-entity-type="media" data-entity-uuid="26f3d8c7-eb32-4dbd-b22e-e26443bb7028" data-entity-substitution="canonical" title="Agent Broker Compensation and Discriminatory Marketing Practices">Frequently Asked Questions on Agent/Broker Compensation and Discriminatory Marketing Practices (PDF)</a></li><li>June 7, 2022<br><a href="/files/document/agent-broker-compensation-and-guaranteed-availability-coverage.pdf" data-entity-type="media" data-entity-uuid="eb322e9a-acf5-4cee-a65f-f8d1585eec7d" data-entity-substitution="canonical" title="Agent-Broker-Compensation-and-Guaranteed-Availability-of-Coverage">Frequently Asked Questions on Agent/Broker Compensation and Guaranteed Availability of Coverage (PDF)</a></li><li>December 14, 2022<br><a href="/files/document/clarifying-guidance-on-the-frequently-asked-questions-on-agent-and-broker-compensation-and-guaranteed-availability-of-coverage.pdf" data-entity-type="media" data-entity-uuid="263688ab-89d3-4dc9-8cf5-8624badd611a" data-entity-substitution="canonical" title="clarifying-guidance-on-the-frequently-asked-questions-on-agent-and-broker-compensation-and-guaranteed-availability-of-coverage">Clarifying Guidance on the Frequently Asked Questions on Agent/Broker Compensation and Guaranteed Availability of Coverage (PDF)</a></li><li>May 24, 2023<br><a href="/files/document/benefit-coordination-and-medicare-eligibility.pdf" data-entity-type="media" data-entity-uuid="2bc30f2d-c373-4272-b968-1264356ad157" data-entity-substitution="canonical" title="Benefit Coordination and Medicare Eligibility">Benefit Coordination and Medicare Eligibility (PDF)</a></li><li>May 31, 2023<br><a href="/cciio/resources/fact-sheets-and-faqs/downloads/faq_on_qhps_and_plan_data_05312023.pdf" data-entity-type="media" data-entity-uuid="e243acb4-cd72-4cb8-b0d4-0b012c317b86" data-entity-substitution="canonical" title="FAQ Plan Data Guaranteed Availability 05312023">Frequently Asked Question on Qualified Health Plans and Plan Data Submissions (PDF)</a></li></ul><h3><a class="ck-anchor" id="Annual_Limits"></a>Annual Limits</h3><p><strong>FAQs</strong></p><ul><li>February 10, 2012<br><a href="/cciio/programs-and-initiatives/health-insurance-market-reforms/alw-faq" data-entity-type="node" data-entity-uuid="25b8d329-8316-4e60-9b04-bb77654873d2" data-entity-substitution="canonical" title="Questions and Answers Related to Annual Limit Waivers">Questions and Answers Related to Annual Limit Waivers</a></li></ul><h3><a class="ck-anchor" id="Coverage_for_Young_Adults"></a>Coverage for Young Adults</h3><p><strong>Fact Sheets</strong></p><ul><li>April 20, 2010<br><a href="/cciio/resources/files/adult_child_fact_sheet" data-entity-type="node" data-entity-uuid="c3f7b384-e18c-485e-9f00-19e0d2cefe59" data-entity-substitution="canonical" title="Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses">Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses</a></li></ul><p><strong>FAQs</strong></p><ul><li>June 29, 2010<br><a href="/cciio/resources/files/adult_child_faq" data-entity-type="node" data-entity-uuid="e0a68ead-b561-4d76-b5af-1cb16008df22" data-entity-substitution="canonical" title="Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Businesses and Families">Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Businesses and Families</a></li></ul><h3><a class="ck-anchor" id="Grandfathered_Plans"></a>Grandfathered Plans</h3><p><strong>Fact Sheets</strong></p><ul><li>November 17, 2010<br><a href="/cciio/resources/files/factsheet_grandfather_amendment" data-entity-type="node" data-entity-uuid="dea0be54-169c-4a68-9e53-92e0f4e92d77" data-entity-substitution="canonical" title="Amendment to Regulation on “Grandfathered” Health Plans under the Affordable Care Act">Amendment to Regulation on “Grandfathered” Health Plans under the Affordable Care Act</a></li></ul><h3><a class="ck-anchor" id="Medical_Loss_Ratio"></a>Medical Loss Ratio</h3><p><strong>Fact Sheets</strong></p><ul><li>November 22, 2010<br><a href="/cciio/resources/fact-sheets-and-faqs/medical-loss-ratio" data-entity-type="node" data-entity-uuid="b94a4b92-f29a-42ad-a2b8-57b500f6a06c" data-entity-substitution="canonical" title="Medical Loss Ratio: Getting Your Money's Worth on Health Insurance">Medical Loss Ratio: Getting Your Money’s Worth on Health Insurance</a></li><li>December 2, 2011<br><a href="/cciio/resources/fact-sheets-and-faqs/mlrfinalrule" data-entity-type="node" data-entity-uuid="7c796321-6ac4-454b-91a0-311eb75f5cc5" data-entity-substitution="canonical" title="Medical Loss Ratio: Getting Your Money's Worth on Health Insurance">Medical Loss Ratio: Final Rule</a></li><li>February 16, 2012<br><a href="/cciio/programs-and-initiatives/health-insurance-market-reforms/rebate-estimates" data-entity-type="node" data-entity-uuid="be214e3c-757f-4661-846d-54ccbb809149" data-entity-substitution="canonical" title="Potential Rebates Saved by HHS Determinations">Potential Estimated Rebates Saved by HHS Determinations on State MLR Adjustment Applications</a></li><li>November 30, 2012<br><a href="/cciio/resources/files/downloads/proposed-payment-notice-technical-summary-11-30-20.pdf" data-entity-type="media" data-entity-uuid="3425d94b-f008-490b-a2c6-6d49b6a66652" data-entity-substitution="canonical" title="proposed-payment-notice-technical-summary-11-30-20">Technical Fact Sheet: Draft Notice of Payment and Benefit Parameters (PDF – 117 KB) (PDF)</a></li></ul><h3><a class="ck-anchor" id="Prevention"></a>Prevention</h3><p><strong>Fact Sheets</strong></p><ul><li>June 28, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/womens-preven-02012013" data-entity-type="node" data-entity-uuid="f4e9e10c-5f23-4e08-90db-4d3d56498a51" data-entity-substitution="canonical" title="Women’s Preventive Services Coverage and Non-Profit Religious Organizations">Women's Preventive Services Coverage and Non-Profit Religious Organizations</a></li></ul><h3><a class="ck-anchor" id="Review_of_Insurance_Rates"></a>Review of Insurance Rates</h3><p><strong>Fact Sheets</strong></p><ul><li>December 21, 2010<br><a href="/cciio/resources/fact-sheets-and-faqs/ratereview" data-entity-type="node" data-entity-uuid="4b1f9146-3bb8-4286-8eea-1586d484ff46" data-entity-substitution="canonical" title="Shining a Light on Health Insurance Rate Increases">Shining a Light on Health Insurance Rate Increases</a></li><li>February 24, 2011<br><a href="/cciio/resources/fact-sheets-and-faqs/ratereview02242011a" data-entity-type="node" data-entity-uuid="79506fe2-19c7-4f2a-89c4-720c38311fc6" data-entity-substitution="canonical" title="Nearly $200 Million Available to Help States Fight Health Insurance Premium Increases">Nearly $200 Million Available to Help States Fight Health Insurance Premium Increases</a></li><li>May 19, 2011<br><a href="/cciio/resources/fact-sheets-and-faqs/ratereview05192011a" data-entity-type="node" data-entity-uuid="011185c4-9536-4bfb-aed9-38d508b18954" data-entity-substitution="canonical" title="Fighting Unreasonable Health Insurance Premium Increases">Fighting Unreasonable Health Insurance Premium Increases</a></li><li>September 20, 2011<br><a href="/cciio/resources/fact-sheets-and-faqs/rate-review09202011a" data-entity-type="node" data-entity-uuid="b273b087-bab6-4677-bdc9-63aa479154c1" data-entity-substitution="canonical" title="Over $100 Million to Help States Crack Down on Unreasonable Health Insurance Rate Hikes">Over $100 Million to Help States Crack Down on Unreasonable Health Insurance Rate Hikes</a></li><li>September 21, 2012<br><a href="/cciio/resources/rate-review-grants" data-entity-type="node" data-entity-uuid="304bb37a-3c60-4050-9405-86296ceedcdb" data-entity-substitution="canonical" title="Rate Review Grants">Rate Review Grant Map: State-by-State Summary of Rate Review Grants</a></li><li>November 20, 2012<br><a href="/cciio/resources/files/downloads/market-rule-nprm-err-technical-summary-11-20-2012.pdf" data-entity-type="media" data-entity-uuid="5e9cdf13-22fa-42f3-bade-36fe387bdb02" data-entity-substitution="canonical" title="market-rule-nprm-err-technical-summary-11-20-2012">Technical Fact Sheet: Proposed Effective Rate Review Rule Changes for Health Insurance Market Reforms (PDF - 70 KB) (PDF)</a></li><li>May 3, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/rate_review_fact_sheet" data-entity-type="node" data-entity-uuid="c357c2fd-55c9-4444-8711-cd5f859d1462" data-entity-substitution="canonical" title="State Effective Rate Review Programs">States with Effective Rate Review Programs</a></li></ul><p><strong>FAQs</strong></p><ul><li>June 7, 2010<br><a href="/cciio/resources/files/premium_review_qa" data-entity-type="node" data-entity-uuid="b5ec6335-6a54-485d-a182-4240f6bda078" data-entity-substitution="canonical" title="Ensuring That Consumers Get Value for Their Dollars | cciio.cms.gov">Premium Review Grant Solicitations: FAQs</a></li><li>July 1, 2010<br><a href="/cciio/resources/files/grant_proposal_review_qa_7-1-2010" data-entity-type="node" data-entity-uuid="0db38890-4bc2-4e49-a98d-c5fed89899db" data-entity-substitution="canonical" title="Office of Consumer Information and Insurance Oversight Affordable Care Act Grants to States for Health Insurance Premium Review-Cycle I Q & As for Grant Proposals (posted July 1, 2010)">Grant Proposals: FAQs</a></li><li>August 22, 2011<br><a href="/cciio/resources/files/rate_review_training" data-entity-type="node" data-entity-uuid="bbf9471a-e68c-457b-a791-5cb306d36cdf" data-entity-substitution="canonical" title="Rate Review Training">Rate Review Training: Technical FAQs - Set 1</a></li><li>October 24, 2011<br><a href="/cciio/resources/training-resources/rate_review_faq" data-entity-type="node" data-entity-uuid="0234e0aa-dcc0-453b-afee-20bca09fcbfd" data-entity-substitution="canonical" title="Rate Review Training">Rate Review Training: Technical FAQs - Set 2</a></li><li>May 8, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/rr-foa-faq-5-8-2013" data-entity-type="node" data-entity-uuid="0e6e5ea4-d7e3-4744-8d2d-acf5f9ee2509" data-entity-substitution="canonical" title="Grants to States to Support Health Insurance Rate Review and Increase Transparency in Health Care Pricing">Rate Review Grants: Cycle III funding opportunity FAQs - Set 1</a></li><li>June 6, 2013<br><a href="/cciio/resources/fact-sheets-and-faqs/rr-foa-faq-6-6-2013" data-entity-type="node" data-entity-uuid="0434d872-ba5e-49c0-aa6b-fe16bdc4c910" data-entity-substitution="canonical" title="Rate Review Cycle III Funding Opportunity: Frequently Asked Questions">Rate Review Grants: Cycle III funding opportunity FAQs - Set 2</a></li></ul><h3><a class="ck-anchor" id="Student_Health_Plans"></a>Student Health Plans</h3><p><strong>Fact Sheet</strong></p><ul><li>February 9, 2011<br><a href="/cciio/resources/fact-sheets-and-faqs/students02092011a" data-entity-type="node" data-entity-uuid="808fcaf1-d996-47e0-8f12-3223724ce4a4" data-entity-substitution="canonical" title="Improving Health Insurance Protections for Students">Improving Health Insurance Protections for Students</a></li><li>March 16, 2012<br><a href="/cciio/resources/fact-sheets-and-faqs/student-health-plans03162012a" data-entity-type="node" data-entity-uuid="d8a97233-6016-431c-930f-4ebdbc7f91f1" data-entity-substitution="canonical" title="Student Health Plans and the Affordable Care Act">Student Health Plans Final Rule</a></li></ul><p><strong>FAQs</strong></p><ul><li>March 9, 2011<br><a href="/cciio/resources/fact-sheets-and-faqs/student_healthinsurance_faqs" data-entity-type="node" data-entity-uuid="bafdff38-394a-44eb-a5fb-97deadec4260" data-entity-substitution="canonical" title="Improving Health Insurance Protections for Students">Status of Student Health Insurance Coverage with Policy Years Starting Prior to January 1, 2012</a> </li></ul><h3><a class="ck-anchor" id="Self-Funded Non-Federal Governmental Plans"></a>Self-Funded, Non-Federal Governmental Plans</h3><p><strong>Fact Sheet</strong></p><ul><li>July 18, 2014<br><a href="/cciio/resources/fact-sheets-and-faqs/non_federal_governmental_plans_04072011" data-entity-type="node" data-entity-uuid="74304d42-82cf-4bf9-92c4-f10fc5974993" data-entity-substitution="canonical" title="Self-Funded, Non-Federal Governmental Plans">Self-Funded Non-Federal Governmental Plans</a></li></ul></div></div> <div class="field field--name-field-downloads 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